Equity of Health Resource Distribution in Community Health Service Institutions in China

Abstract

Objective: To investigate the equity of health resource distribution in community health service institutions in China and to provide scientific basis for further optimization of health resource distribution and rational formulation of development strategies for community health service.

Methods: Based on National Health Expenditure Report 2015, China’s Health Statistics 2005—2013, China’s Health and Family Planning Statistics 2014—2015, the health expenditure, number of institutions, number of beds and number of health technicians of community health service institutions from 2005 to 2014 were obtained in China to analyze the development trend of health resource distribution in community health service institutions and to explore its equity by Lorenz curves and Gini coefficient.

Results: From 2005 to 2014, the health expenditure, number of institutions, number of beds and number of health technicians in community health service institutions in China increased by 80.499 billion yuan, 17 110, 170 895 and 385 207 respectively with an average annual growth rate of 31.91%, 8.00%, 25.69% and 18.82%. The Lorenz curve showed that the fairness of health expenditure, number of institutions, number of beds and number of health technicians by population distribution were higher than that of the distribution by area nationwide as well as in the eastern, central, and western regions in 2014. In 2014, the Gini coefficients of health expenditure, number of institutions, number of beds and number of health technicians by population distribution nationwide in community health service institutions were 0.56, 0.36, 0.27 and 0.29 respectively, while those based on area distribution were 0.84, 0.73, 0.70 and 0.73 respectively. Gini coefficients of the above indicators by population distribution in the eastern region were 0.54, 0.35, 0.31 and 0.29 respectively, while those based on area distribution were 0.69, 0.50, 0.48 and 0.46 respectively. Gini coefficients of the above indicators by population distribution in the central region were 0.23, 0.21, 0.15 and 0.14 respectively, while those based on area distribution were 0.30, 0.38, 0.30 and 0.27 respectively. Gini coefficients of the above indicators by population distribution in the western region were 0.30, 0.32, 0.29 and 0.22 respectively, while those based on area distribution were 0.66, 0.50, 0.62 and 0.59 respectively.

Conclusion: The health resource distribution in community health service institutions is developing rapidly in China. In 2014, the fairness of health resource distribution by population distribution was higher than that of the distribution by area nationwide as well as in the eastern, central and western regions of China. There are problems of uneven development and unfair distribution among different regions, while health resource distribution in the central region is fairly fair. The government should formulate health policies in line with the development situation of the region according to its local population and economic conditions to allocate health resources fairly and reasonably in order to improve the fairness of health services.