Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China
Abstract Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province an...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-022-01741-1 |
| _version_ | 1818016797649010688 |
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| author | Wanmin Su Liulin Du Yujun Fan Peixi Wang |
| author_facet | Wanmin Su Liulin Du Yujun Fan Peixi Wang |
| author_sort | Wanmin Su |
| collection | DOAJ |
| description | Abstract Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation. Methods Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency. |
| first_indexed | 2024-04-14T07:18:22Z |
| format | Article |
| id | doaj.art-0001c83a993047c5843bc2e3198b8063 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-14T07:18:22Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-0001c83a993047c5843bc2e3198b80632022-12-22T02:06:15ZengBMCInternational Journal for Equity in Health1475-92762022-09-0121111810.1186/s12939-022-01741-1Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, ChinaWanmin Su0Liulin Du1Yujun Fan2Peixi Wang3School of Nursing and Health, Henan UniversityThe Seventh Affiliated Hospital, Southern Medical UniversitySchool of Nursing and Health, Henan UniversitySchool of Nursing and Health, Henan UniversityAbstract Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation. Methods Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.https://doi.org/10.1186/s12939-022-01741-1Public hospitalsHealth resource allocationEquityEfficiencyGuangdong Province-China |
| spellingShingle | Wanmin Su Liulin Du Yujun Fan Peixi Wang Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China International Journal for Equity in Health Public hospitals Health resource allocation Equity Efficiency Guangdong Province-China |
| title | Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China |
| title_full | Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China |
| title_fullStr | Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China |
| title_full_unstemmed | Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China |
| title_short | Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China |
| title_sort | equity and efficiency of public hospitals health resource allocation in guangdong province china |
| topic | Public hospitals Health resource allocation Equity Efficiency Guangdong Province-China |
| url | https://doi.org/10.1186/s12939-022-01741-1 |
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