Equity and efficiency of public maternal and child health institution’ health resource allocation in Henan Province, China

Abstract

Background Henan Province is the third largest population province in China. This study aims to evaluate the equity, efficiency and productivity of maternal and child health (MCH) resource allocation in Henan Province using the most recent data, analyse the causes of deficiencies, and discuss measures to solve these problems. Methods Data sources were from the Henan Statistical Yearbook (2017–2021) and Henan Annual Monitoring Report of Public Hospitals (2016–2020). The Gini coefficient (G), Theil index (T) and health resource density index (HRDI) were chosen to study the fairness of health resource allocation in Henan Province. Correlation analysis and cluster analvsis were used to determine the input and output indexes. Data envelopment analysis (DEA) and the Malmquist productivity index (MPI) were used to analyse the efficiency and productivity of this allocation. Tobit Regression Model was used to explore the influence factors of efficiency. Results From 2016 to 2020, the G of beds, health technicians and government financial subsidies in Henan Province remained below 0.3 according to population and geographical allocation, but the fairness of beds and health technicians was better than that of government finance, and the fairness of population allocation was better than that of geographical allocation. The results of T show that inequality mainly comes from intra-regional differences, and the Central Urban Agglomeration (CUA) contributes the most to the overall difference. Although the HRDI of CUA is much larger than that of other regions, there are obvious differences among cities in the region. During 2016 to 2020, less than half of the cities in Henan are DEA efficient each year, and health technicians, building business room area, and the number of are outpatients external factors that affect efficiency. Conclusion The overall fairness of MCH resources allocation is good but the efficiency is low. The fairness of beds and health technicians are better than that of government financial subsidies, and the fairness of population allocation is better than that of geographical allocation. In addition, there are obvious regional differences in the geographical distribution of health resources. Henan Province needs to further optimize the allocation of resources and improve utilization efficiency.