Inequality of obstetric and gynaecological workforce distribution in China

Abstract

BackgroundWomen’s health is defined as a continuum throughout their whole lives. In China, women receive life-round preventative and curative health care from the health system, although the universal access to reproductive health has already been basically achieved in China, the situation of women’s access to curative health care is still unknown.MethodsData from the national maternal and child health human resource investigation were analysed. Lorenz curves, Gini coefficients, and Theil L indexes were drawn and calculated to reflect the inequality. Demographically, we found that the Obstetric and gynaecological (OB/GYN) workforce was the least equitable regarding the distribution of live births.ResultsDemographically, we found that the OB/GYN workforce was the least equitable regarding the distribution of live births. The geographic distribution of the OB/GYN workforce was found to be severely inequitable, especially in the West region. Most of the inequality was found to come from inner-regions.ConclusionFor the first time, the distribution inequality of OB/GYN workforce in China was analysed. The findings in this study can be adopted in making national or regional OB/GYN workforce allocation policies, but further studies are still needed to reveal the detailed sources of inequality and to provide evidence for local policy-making.Electronic supplementary materialThe online version of this article (10.1186/s12939-017-0716-6) contains supplementary material, which is available to authorized users.

Measuring inequalities in the demographical and geographical distribution of physicians in China: Generalist versus specialist

“…The demographical distributions of total physicians indicate absolute equality with Gini coefficients lower than 0.1, whereas the geographical distributions of total physicians are in severe inequality with Gini coefficients higher than 0.6. Similar results have been reported in previous studies . Not only China but also other developing countries, such as Mexico and Vietnam, are undergoing severe inequality regarding geographical distribution of health workers .…”

“…Therefore, it is meaningful to investigate the distribution inequality of the 2 types of physicians in a country or a region. Most previous studies in this regard have measured the maldistribution of either generalist or specialist physicians and demonstrated various degrees of inequality. Few comparative studies have merely compared the quantity and proportion of generalist with those of specialist physicians or measured the inequalities in the utilisation of generalist and specialist health care services .…”

Evaluation of resource utilization efficiency in obstetrics and gynecology units in China: A three‐stage data envelopment analysis of the Shanxi province

“…The efficiency scores are calculated according to input and output indicators of each unit. The inclusion principles of input and output variables were as follows: (a) Since China is a developing country, the efficiency studies of health systems mainly focus on quantifiable medical services; (b) the distribution of gynecological and obstetric health care resources in China is not equal, with the largest problem encountered in the backward province of Shanxi, where meeting the high number of medical services required by patients is causing considerable challenges; and (c) although the China Hospital Association (CHA) encourages nurses to report adverse events, under‐reporting is still a significant issue . Biased interpretations lead to inaccurate descriptions of patient safety; therefore, there is a need to avoid selecting patient safety indicators, such as mortality rates, infection rates, and other indicators, that the report rates, as they are not accurate, especially in a backward province.…”

“…We adopted the input‐oriented DEA model in this study for the following reasons. First, the model has been successfully used to improve health care unit efficiency and reduce actual health care costs, in other related studies . Second, maternal resources in China are relatively scarce, and how to maximize the allocation of resources is an important issue .…”

“…First, the model has been successfully used to improve health care unit efficiency and reduce actual health care costs, in other related studies . Second, maternal resources in China are relatively scarce, and how to maximize the allocation of resources is an important issue . Third, since the number of discharged patients is not controlled by the administrator, the DEA model can be applied to the problem of how to optimize the input resources, under the condition of constant output.…”