Analysis of fairness and trends in the allocation of medical and health resources in Shanghai from 1995 to 2018_Chinese Journal of Evidence-Based Medicine

Authors：

 CAI Xuechen , ZHANG Qiang , WANG Xueying , ZHANG Jue , WANG Kaishan

School of Management, Shanghai University of Engineering Science, Shanghai 201620, P.R.China;

Corresponding?author：

CAI Xuechen, Email: caicaipianer@163.com

Keywords：

Health resource allocation; Fairness; Shanghai

DOI：

10.7507/1672-2531.202104064

Video：

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Objective To evaluate the equity of health care resource allocation in Shanghai and the changing trends from 1995 to 2018.Methods Being based on the Gini coefficient and the Theil index, the equity of health care resource allocation in Shanghai from 1995 to 2018 was comprehensively evaluated from the perspective of "demographic equity" and "geographic equity", and the Mann-Kendall non-parametric test was used to predict the trends of changes.Results The Gini coefficient of the distribution of medical and health resources by population in Shanghai from 1995 to 2018 was 0.225 9 to 0.411 9, and the configuration was in a normal or optimal state with an increasing trend. The Gini coefficient distributed by geographic area was 0.892 4 to 0.979 3, which was in a disadvantaged state and a decreasing trend. The overall Theil index ranged from 0.010 9 to 0.058 1, which was a more equitable configuration, but with a decreasing trend. In addition, both the Gini coefficient and the Theil index showed that equity improvements were mainly influenced by the number of health facilities and beds, with health facilities contributing the most to equity, while the disparity in health technician staffs was the main reason for the decline in equity. Inequities in the allocation of health facilities and the number of beds originated mainly within regions, while inequities in the allocation of health technicians originated mainly between regions.Conclusions The allocation of health care resources in Shanghai is more equitable and the equity has been on the rise in recent years. However, at the present stage, there is still a contradiction between equitable allocation by population and inequitable allocation by geographic area, and in the future, there is a contradiction between the tendency of inequitable allocation by population and the tendency of equitable allocation by geographic area. Optimizing the allocation of health technicians is the key to improving equity, and addressing regional differences in allocation is an effective way to optimize the allocation of health technicians.

Citation： CAI Xuechen, ZHANG Qiang, WANG Xueying, ZHANG Jue, WANG Kaishan. Analysis of fairness and trends in the allocation of medical and health resources in Shanghai from 1995 to 2018. Chinese Journal of Evidence-Based Medicine, 2021, 21(9): 1016-1023. doi: 10.7507/1672-2531.202104064 Copy

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1. 雷鵬, 馮志昕, 丁荊妮, 等. 中國醫療資源配置與服務利用現狀評價. 衛生經濟研究, 2019, 36(5): 50-55.
2. 張強, 高向東. 上海市老年人口空間分布及演變趨勢研究. 人口與發展, 2017, 23(6): 46-54, 108.
3. 鐘愛軍, 編著. Excel 在財務與會計中的高級應用. 武漢: 武漢大學出版社, 2012.
4. 曾文麒, 陶文娟, 嚴玲, 等. 四川省兒科衛生資源配置與公平性研究. 中國循證醫學雜志, 2018, 18(3): 267-270.
5. 季舒銘, 王維, 張佩, 等. 分級診療背景下醫院人力資源配置的合理性研究. 中國循證醫學雜志, 2020, 20(9): 1004-1011.
6. 景麗偉, 張超, 孫書彥, 等. 北京市醫養結合資源配置現狀及公平性研究. 中國衛生政策研究, 2020, 13(3): 49-56.
7. 常遠勇, 侯西勇, 毋亭, 等. 1998-2010 年全球中低緯度降水時空特征分析. 水科學進展, 2012, 23(4): 475-484.
8. 李中凱, 李金葉. 中國西北五省 2006-2017 年醫療資源配置公平性分析. 中國循證醫學雜志, 2020, 20(11): 1266-1273.
9. 國務院辦公廳. 關于印發《全國醫療衛生服務體系規劃綱要(2015-2020 年)》的通知(國辦發〔2015〕14 號). Available at: http://www.gov.cn/zhengce/content/2015-03/30/content_9560.htm?trs=1.
10. 上海市人民政府. 關于印發《上海市衛生計生改革和發展“十三五”規劃》的通知(滬府發〔2016〕57 號). Available at: https://www.shanghai.gov.cn/nw2/nw2314/nw39309/nw39385/nw40603/u26aw48386.html?knohdbiekfkfcbai.
11. 國務院辦公廳. 關于印發《“健康中國 2030”規劃綱要》的通知(國辦發〔2016〕32 號). Available at: http://www.gov.cn/gongbao/2016-11/20/content_5133024.htm.
12. 唐齊鑫, 鞠啟明, 魯鋒, 等. 我國衛生資源配置公平性與效率分析. 現代預防醫學, 2018, 45(6): 1043-1047.
13. 王玲, 張翔. 2004-2008 年上海市衛生資源公平性研究. 中國衛生事業管理, 2010, 27(2): 85-87, 107.
14. Han J, Jiang W, Shi J, et al. A method for assessing the fairness of health resource allocation based on geographical grid. Comp Mat Cont, 2020, 64(2): 1171-1184.
15. Love-Koh J, Griffin S, Kataika E, et al. Methods to promote equity in health resource allocation in low- and middle-income countries: an overview. Global Health, 2020, 16(1): 6.
16. 彭蓉, 鄧蒙, 覃嫻靜, 等. 2015-2017 年廣西衛生資源配置現狀及公平性研究. 中國衛生政策研究, 2020, 13(3): 57-63.
17. Owili PO, Hsu YH, Chern JY, et al. Perceptions and attitudes of health professionals in kenya on national health care resource allocation mechanisms: a structural equation modeling. PLoS One, 2015, 10(6): e0127160.
18. Anselmi L, Lagarde M, Hanson K. Equity in the allocation of public sector financial resources in low- and middle-income countries: a systematic literature review. Health Policy Plan, 2015, 30(4): 528-545.
19. 劉曉珊, 張欣雨, 然娜·阿哈提, 等. 新醫改前后我國中醫類醫院醫療衛生資源配置變化研究. 中國衛生經濟, 2020, 39(4): 49-53.
20. 上海市人民政府. 關于印發《上海市區域衛生規劃(2011 年-2020 年)》的通知(滬府發〔2013〕6 號). Available at: https://www.shsmu.edu.cn/xkghc/info/1027/1096.htm.

Chinese Journal of Evidence-Based Medicine

Analysis of fairness and trends in the allocation of medical and health resources in Shanghai from 1995 to 2018

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