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

Wu, Jingxian

doi:10.1002/hpm.2539

Cited by 22 publications

(17 citation statements)

References 31 publications

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“…It is an inequality measure without considering the spatial distribution of data. A previous study reported that the Gini coefficients for physicians by population and by area across the 31 provinces of China were 0.2 and 0.7, respectively; thus, we calculated the coefficients using Shenzhen data [36].…”

Section: Methodsmentioning

confidence: 99%

“…X i represents the cumulative proportion of i population or area and Y i represents the corresponding cumulative proportion of medical resources. Gini coefficients were calculated using the formula below; a Gini coefficient of 0 expresses perfect equality, while a value of 1 indicates maximal inequality [36]. G=1−∑i=0n−1(Yi+1+Yi)(Xi+1−Xi)…”

Section: Methodsmentioning

confidence: 99%

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Assessing Spatial Accessibility to Medical Resources at the Community Level in Shenzhen, China

Zhu

Zhong

et al. 2019

IJERPH

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Spatial accessibility to medical resources is an integral component of universal health coverage. However, research evaluating the spatial accessibility of healthcare services at the community level in China remains limited. We assessed the community-level spatial access to beds, doctors, and nurses at general hospitals and identified the shortage areas in Shenzhen, one of the fastest growing cities in China. Based on hospital and population data from 2016, spatial accessibility was analyzed using several methods: shortest path analysis, Gini coefficient, and enhanced 2-step floating catchment area (E2SFCA). The study found that 99.9% of the residents in Shenzhen could get to the nearest general hospital within 30 min. Healthcare supply was much more equitable between populations than across communities in the city. E2SFCA scores showed that the communities with the best and worst hospital accessibility were found in the southwest and southeast of the city, respectively. State-owned public hospitals still dominated the medical resources supply market and there was a clear spatial accessibility disparity between private and public healthcare resources. The E2SFCA scores supplement more details about resource disparity over space than do crude provider-to-population ratios (PPR) and can help improve the efficiency of the distribution of medical resources.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Assessing Spatial Accessibility to Medical Resources at the Community Level in Shenzhen, China

Zhu

Zhong

et al. 2019

IJERPH

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“…On the one hand, they need to respond to the general public, which is why they also invest heavily in public health care, especially primary care. 54,55 Our regression results demonstrate that the local population is an important determinant behind the regional distribution of NTH, TH and GATH. Without a significant increase in the general public's health benefits, the government could hardly claim the legitimacy of the communist party's ruling.…”

Section: Reasoningmentioning

confidence: 69%

The cream‐skimming effect in China's health care services: A mixed methods study

Chen

Lang

2020

Health Planning & Management

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Objective: One of the greatest inequities in China's health care service is that between senior cadres, high-level bureaucrats, and the general public in terms of hospital access and payment. We aim to demonstrate this inequity and to explore its connection with the regional inequity of different levels of health care facilities. Methods: In a content analysis of official websites of provincial health bureaus and national top hospitals, we determine whether senior cadres enjoy priority in health services with fewer payments. Then, we employ multiple regression analyses to explore the correlation of the local economy, the local population as well as the regional power and different levels of health care facilities. Results: The content analysis suggests that senior cadres indeed enjoy priority in health care services. According to the regression results, the local population has a positive correlation with every level of health care facilities except the highest one, which is responsive only to the local power index. Conclusion: We demonstrate a demand-side creamskimming effect in China's health care service. Senior cadres have taken the 'cream', the best services, and the individual inequity between senior cadres and the general public is related to the regional inequity of different-level health care facilities.

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“…With the Gini coefficient as an indicator of distribution inequity, China has a severe geographical disparity in physicians (a Gini coefficient higher than 0.6), and this trend is worsening (9,10). The distribution of licensed physicians by age warrants attention as well ( Figure 2B).…”

Section: Supply Of Physiciansmentioning

confidence: 99%

Health care reform in China from the perspective of physicians

Lin

Zhou

Wang

2020

BST

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

Cited by 22 publications

References 31 publications

Assessing Spatial Accessibility to Medical Resources at the Community Level in Shenzhen, China

Assessing Spatial Accessibility to Medical Resources at the Community Level in Shenzhen, China

The cream‐skimming effect in China's health care services: A mixed methods study

Health care reform in China from the perspective of physicians

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