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

1.	雷鹏, 冯志昕, 丁荆妮, 等. 中国医疗资源配置与服务利用现状评价. 卫生经济研究, 2019, 36(5): 50-55.
2.	张强, 高向东. 上海市老年人口空间分布及演变趋势研究. 人口与发展, 2017, 23(6): 46-54, 108.
3.	钟爱军, 编著. Excel 在财务与会计中的高级应用. 武汉: 武汉大学出版社, 2012.
4.	曾文麒, 陶文娟, 严玲, 等. 四川省儿科卫生资源配置与公平性研究. 中国循证医学杂志, 2018, 18(3): 267-270.
5.	季舒铭, 王维, 张佩, 等. 分级诊疗背景下医院人力资源配置的合理性研究. 中国循证医学杂志, 2020, 20(9): 1004-1011.
6.	景丽伟, 张超, 孙书彦, 等. 北京市医养结合资源配置现状及公平性研究. 中国卫生政策研究, 2020, 13(3): 49-56.
7.	常远勇, 侯西勇, 毋亭, 等. 1998-2010 年全球中低纬度降水时空特征分析. 水科学进展, 2012, 23(4): 475-484.
8.	李中凯, 李金叶. 中国西北五省 2006-2017 年医疗资源配置公平性分析. 中国循证医学杂志, 2020, 20(11): 1266-1273.
9.	国务院办公厅. 关于印发《全国医疗卫生服务体系规划纲要(2015-2020 年)》的通知(国办发〔2015〕14 号). Available at: http://www.gov.cn/zhengce/content/2015-03/30/content_9560.htm?trs=1.
10.	上海市人民政府. 关于印发《上海市卫生计生改革和发展“十三五”规划》的通知(沪府发〔2016〕57 号). Available at: https://www.shanghai.gov.cn/nw2/nw2314/nw39309/nw39385/nw40603/u26aw48386.html?knohdbiekfkfcbai.
11.	国务院办公厅. 关于印发《“健康中国 2030”规划纲要》的通知(国办发〔2016〕32 号). Available at: http://www.gov.cn/gongbao/2016-11/20/content_5133024.htm.
12.	唐齐鑫, 鞠启明, 鲁锋, 等. 我国卫生资源配置公平性与效率分析. 现代预防医学, 2018, 45(6): 1043-1047.
13.	王玲, 张翔. 2004-2008 年上海市卫生资源公平性研究. 中国卫生事业管理, 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, 邓蒙, 覃娴静, 等. 2015-2017 年广西卫生资源配置现状及公平性研究. 中国卫生政策研究, 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.	刘晓珊, 张欣雨, 然娜·阿哈提, 等. 新医改前后我国中医类医院医疗卫生资源配置变化研究. 中国卫生经济, 2020, 39(4): 49-53.
20.	上海市人民政府. 关于印发《上海市区域卫生规划(2011 年-2020 年)》的通知(沪府发〔2013〕6 号). Available at: https://www.shsmu.edu.cn/xkghc/info/1027/1096.htm.

1. 雷鹏, 冯志昕, 丁荆妮, 等. 中国医疗资源配置与服务利用现状评价. 卫生经济研究, 2019, 36(5): 50-55.
2. 张强, 高向东. 上海市老年人口空间分布及演变趋势研究. 人口与发展, 2017, 23(6): 46-54, 108.
3. 钟爱军, 编著. Excel 在财务与会计中的高级应用. 武汉: 武汉大学出版社, 2012.
4. 曾文麒, 陶文娟, 严玲, 等. 四川省儿科卫生资源配置与公平性研究. 中国循证医学杂志, 2018, 18(3): 267-270.
5. 季舒铭, 王维, 张佩, 等. 分级诊疗背景下医院人力资源配置的合理性研究. 中国循证医学杂志, 2020, 20(9): 1004-1011.
6. 景丽伟, 张超, 孙书彦, 等. 北京市医养结合资源配置现状及公平性研究. 中国卫生政策研究, 2020, 13(3): 49-56.
7. 常远勇, 侯西勇, 毋亭, 等. 1998-2010 年全球中低纬度降水时空特征分析. 水科学进展, 2012, 23(4): 475-484.
8. 李中凯, 李金叶. 中国西北五省 2006-2017 年医疗资源配置公平性分析. 中国循证医学杂志, 2020, 20(11): 1266-1273.
9. 国务院办公厅. 关于印发《全国医疗卫生服务体系规划纲要(2015-2020 年)》的通知(国办发〔2015〕14 号). Available at: http://www.gov.cn/zhengce/content/2015-03/30/content_9560.htm?trs=1.
10. 上海市人民政府. 关于印发《上海市卫生计生改革和发展“十三五”规划》的通知(沪府发〔2016〕57 号). Available at: https://www.shanghai.gov.cn/nw2/nw2314/nw39309/nw39385/nw40603/u26aw48386.html?knohdbiekfkfcbai.
11. 国务院办公厅. 关于印发《“健康中国 2030”规划纲要》的通知(国办发〔2016〕32 号). Available at: http://www.gov.cn/gongbao/2016-11/20/content_5133024.htm.
12. 唐齐鑫, 鞠启明, 鲁锋, 等. 我国卫生资源配置公平性与效率分析. 现代预防医学, 2018, 45(6): 1043-1047.
13. 王玲, 张翔. 2004-2008 年上海市卫生资源公平性研究. 中国卫生事业管理, 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, 邓蒙, 覃娴静, 等. 2015-2017 年广西卫生资源配置现状及公平性研究. 中国卫生政策研究, 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. 刘晓珊, 张欣雨, 然娜·阿哈提, 等. 新医改前后我国中医类医院医疗卫生资源配置变化研究. 中国卫生经济, 2020, 39(4): 49-53.
20. 上海市人民政府. 关于印发《上海市区域卫生规划(2011 年-2020 年)》的通知(沪府发〔2013〕6 号). 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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