Measuring health inequalities in Albania: a focus on the distribution of general practitioners

Theodorakis, Pavlos N; Mantzavinis, Georgios D.; Rrumbullaku, Llukan; Lionis, Christos; Trell, Erik

doi:10.1186/1478-4491-4-5

Cited by 67 publications

(67 citation statements)

References 10 publications

(24 reference statements)

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“…According to the Iranian statistical yearbook, This study has shown inequalities in the distribution of human and physical resources in the province. For human resources the Gini coefficients for specialists, general practitioners, dentists, pharmacists and paramedics were found to closely relate to the reports of other previous studies (22,26,27). However, the Gini coefficient for dentists in this study in 2011 was higher than that was reported from Japan (0.255) (28) and lower than the report from previous study across all provinces in Islamic Republic of Iran (0.39) (26).…”

Section: Discussioncontrasting

confidence: 57%

“…A government regulation which allows new graduate general practitioners, dentists, pharmacists and other health professionals to work in remote areas seems to have contributed to the reduction in inequality in the distribution of human resources for health. A previous study also reported that improvement in roads and transportation systems and incentives and promotion opportunities to health workers has contributed to reducing inequalities in the distribution of resources for health (22). Other reasons could have due to improvement in the equity of distribution of health care resources.…”

Section: Discussionmentioning

confidence: 99%

“…We used the Gini coefficient and the index of dissimilarity which are both commonly used in analysing inequality in the distribution of health care resources (10,22,23).…”

Section: Inequality Measures and Data Analysismentioning

confidence: 99%

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Relative inequalities in geographic distribution of health care resources in Kermanshah province, Islamic Republic of Iran

Rezaei

Karyani

Fallah

2016

East Mediterr Health J

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This study aimed to evaluate inequalities in the geographical distribution of human and physical resources in the health sector of Kermanshah province, Islamic Republic of Iran. In a retrospective, cross-sectional study, data from the Statistical Centre of Iran were used to calculate inequality measures (Gini coefficient and index of dissimilarity) over the years 2005-11. The highest Gini coefficient for human resources was observed for pharmacists in 2005 (0.75) and the lowest for paramedics in 2010 and 2011 (0.10). The highest indices of dissimilarity were also for pharmacists in 2005 (29%) and paramedics in 2011 (3%). For physical resources, the highest and lowest Gini coefficients were for rehabilitation centres in 2010 (0.59) and health houses in 2011 (0.12) respectively. Generally, inequalities in the distribution of health care resources were lower at the end of the study period, although there was potential for more equitable distribution of pharmacists, specialists, health houses and beds. ‫اإلسالمية‬ ‫إيران‬ ‫بجمهورية‬ ‫كرمنشاه‬ ‫حمافظة‬ ‫يف‬ ‫الصحية‬ ‫الرعاية‬ ‫ملوارد‬ ‫اجلغرايف‬ ‫التوزيع‬ ‫يف‬ ‫النسبية‬ ‫املساواة‬ ‫عدم‬

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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Relative inequalities in geographic distribution of health care resources in Kermanshah province, Islamic Republic of Iran

Rezaei

Karyani

Fallah

2016

East Mediterr Health J

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“…It also has been widely used to measure the inequality in public transport [3], health facilities [28], energy [29], and ecological footprints [30]. Here, a Gini coefficient is employed to measure the spatial inequality in taxi services.…”

Section: Gini Coefficientmentioning

confidence: 99%

Uncovering Spatial Inequality in Taxi Services in the Context of a Subsidy War among E-Hailing Apps

Fang

Hong

et al. 2018

IJGI

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Spatial inequalities in urban public transportation are a major concern in many countries but little of this research has focused specifically on taxi services. The taxi situation has grown more complex, as traditional ride-for-hire services face growing competition from e-hailing apps like Uber in the U.S., or Didi and Kuaidi in China. In 2014, Didi and Kuaidi triggered a nationwide subsidy war, with possible effects on the spatial inequality of taxi services. Taxi trajectory data from Shenzhen collected during the subsidy war shows that this competition reduced spatial inequality in the inner city but aggravated it in the outer city. In this study, a measure of service rate to depict the quantity of taxi services is proposed to calculate a Gini coefficient for evaluating change in the spatial inequality of taxi services. The Theil index and its decomposition were used to distinguish the contribution of Traffic Analysis Zones (TAZs) in the inner and the outer city and compare them to the overall spatial inequality of taxi services in Shenzhen, TAZs in the outer city had greater inequality in taxi services than the inner city. Furthermore, the primary contributor to overall inequality in taxi services was inequality within, rather than between, the inner and outer city. Moreover, the mean values for the changed service rates in the inner city were always larger than the outer city, and the inner city had a more equitable changed service rate than the outer city. These results could serve as a foundation for improving taxi services citywide.

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“…It calculated as the ratio of the area between the Lorenz curve and the diagonal line, to the whole area below the 45°line [29]. In this study we used the formula provided by M. Brown and manually calculated it.…”

Section: Equity Measuresmentioning

confidence: 99%

Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city

et al. 2015

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Background: Due to reform of the economic system and the even distribution of available wealth, emergency medical services (EMS) experienced greater risks in equity. This study aimed to assess the equity of EMS needs, utilisation, and distribution of related resources, and to provide evidence for policy-makers to improve such services in Chongqing city, China. Methods: Five emergency needs variables (mortality rate of maternal, neonatal, cerebrovascular, cardiovascular, injury and poisoning) from the death surveillance, and two utilisation variables (emergency room visits and rate of utilisation) were collected from Chongqing Health Statistical Year Book 2008 to 2012. We used a concentration index (CI) to assess equality in the distribution of needs and utilisation among three areas with different per-head gross domestic product (GDP). In each area, we randomly chose two districts as sample areas and selected all the medical institutions with emergency services as subjects. We used the Gini coefficient (G) to measure equity in population and geographic distribution of facilities and human resources related EMS. Results: Maternal-caused (CI: range −0.213 to −0.096) and neonatal-caused (CI: range −0.161 to −0.046)deaths declined in 2008-12, which focusing mainly on the less developed area. The maternal deaths were less equitably distributed than neonatal, and the gaps between areas gradually become more noticeable. For cerebrovascular (CI: range 0.106 to 0.455), cardiovascular (CI: range 0.101 to 0.329), injury and poisoning (CI: range 0.001 to 0.301) deaths, we documented a steady improvement of mortality; the overall equity of these mortalities was lower than those of maternal and neonatal mortalities, but distinct decreases were seen over time. The patients in developed area were more likely to use EMS (CI: range 0.296 to 0.423) than those in less developed area, and the CI increased over the 5-year period, suggesting that gaps in equity were increasing. The population distribution of facilities, physicians and nurses (G: range 0.2 to 0.3) was relatively equitable; the geographic distribution (G: range 0.4 to 0.5) showed a big gap between areas. Conclusions: In Chongqing city, equity of needs, utilization, and resources allocation of EMS is low, and the provision of such services has not met the needs of patients. To narrow the gap of equity, improvement in the capability of EMS to decrease cerebrovascular, cardiovascular, injury and poisoning cases, should be regarded as a top priority. In poor areas, allocation of facilities and human resources needs to be improved, and the economy should also be enhanced.

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Measuring health inequalities in Albania: a focus on the distribution of general practitioners

Cited by 67 publications

References 10 publications

Relative inequalities in geographic distribution of health care resources in Kermanshah province, Islamic Republic of Iran

Relative inequalities in geographic distribution of health care resources in Kermanshah province, Islamic Republic of Iran

Uncovering Spatial Inequality in Taxi Services in the Context of a Subsidy War among E-Hailing Apps

Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city

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