The health resource allocation and equity of pediatric care in Sichuan province: a cross-sectional study_Chinese Journal of Evidence-Based Medicine

Authors：

ZENG Wenqi , TAO Wenjuan , YAN Ling ,  WEN Jin

Hospital Management Institute, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

WEN Jin, Email: huaxiwenjin@163.com

Keywords：

Pediatric; Demand of health service; Health resource allocation; Gini coefficient; Fairness

DOI：

10.7507/1672-2531.201710093

Video：

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ObjectiveTo investigate the demand of pediatric health service, the current situation of resource allocation and the equity of health service, so as to provide guidelines for optimizing the resource allocation of pediatric health service in Sichuan province.MethodsA questionnaire of all healthcare institutions with legal capability from a total of 183 prefectures in Sichuan province was performed in 2015. We described the demand of pediatric health service by two-week hospital visit rate, the proportion of no-visit rate within two-weeks, hospital admission rate, and the patient required hospitalization rate. We assessed current situation of resource allocation, equity and accessibility by analyzing Gini coefficient, Lorenz curve and thermodynamic diagram.ResultsThe demand of pediatric health service in Sichuan province was huge and the current resource allocation can be shown a " inverted triangle” form. According to population distribution, the Gini coefficients of physician, bed and equipment were 0.47, 0.40 and 0.49, respectively, which represented inequality in resource allocation. By location, the Gini coefficients of physician, bed and equipment were 0.82, 0.77 and 0.81, respectively, which indicated an absolutely unfair situation.ConclusionsThe health resources of pediatric in Sichuan province are limited, the distribution is unbalanced, and the supply of pediatric healthcare is not compatible with demand. The lack of resources and waste coexist simultaneously. Furthermore, the fairness of distribution in terms of geographical areas is far less than that in terms of population. The accessibility of superior health resources is low.

Citation： ZENG Wenqi, TAO Wenjuan, YAN Ling, WEN Jin. The health resource allocation and equity of pediatric care in Sichuan province: a cross-sectional study. Chinese Journal of Evidence-Based Medicine, 2018, 18(3): 267-270. doi: 10.7507/1672-2531.201710093 Copy

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2. 胡文玲, 金曦, 罗荣, 等. 中国儿科人力资源配置现状及公平性分析. 中国公共卫生, 2016, 32(4): 435-439.
3. Hu KJ, Sun ZZ, Rui YJ, et al. Shortage of pediatricians in China. Lancet, 2014, 383(9921): 954.
4. 蒋瑾瑾, 钱燕, 郭林芳. 综合性医院儿科人才的去留和培养问题初探. 西北医学教育, 2009, 17(1): 73-75.
5. 李奇, 祝益民, 盛小奇, 等. 儿童医疗服务体系现况分析与思考. 中国医院管理, 2012, 32(6): 23-24.
6. 国家卫生和计划生育委员会. 2016 中国卫生和计划生育统计年鉴. 北京: 中国协和医科大学出版社, 2017.
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8. 四川卫生和计划生育年鉴编纂委员会. 2015 四川卫生和计划生育年鉴. 四川: 电子科技大学出版社, 2016.
9. 四川省 1% 人口抽样调查领导小组办公室, 四川省统计局人口和社会科技统计处. 2015 年四川省 1% 人口抽样调查资料. 北京: 中国统计出版社, 2017.
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11. 谢红梅, 潘杰. 医疗卫生服务空间可及性的衡量方法概述. 中国卫生统计, 2016, 33(2): 353-356, 361.
12. Buehler JW, Bernet PM, Ogden LL. Resource and cost adjustment in the design of allocation funding formulas in public health programs. J Public Health Manag Pract, 2012, 18(4): 323-332.
13. De Maio FG. Income inequality measures. J Epidemiol Community Health, 2007, 61(10): 849-852.
14. 孟凡强. 基尼系数研究. 辽宁经济, 2005, (3): 74.
15. Epstein AM. US teaching hospitals in the evolving health care system. JAMA, 1995, 273(15): 1203-1207.
16. 沈松英, 王平, 杨丽, 等. 儿科医疗资源配置对婴儿死亡率的影响. 中国妇幼保健, 2016, 31(9): 1795-1797.
17. Fang P, Dong S, Xiao J, et al. Regional inequality in health and its determinants: evidence from China. Health Policy, 2010, 94(1): 14-25.

Chinese Journal of Evidence-Based Medicine

The health resource allocation and equity of pediatric care in Sichuan province: a cross-sectional study

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