Resource Allocation Equity in the China’s Rural Three-Tier Healthcare System

Abstract

The rural three-tier healthcare system is an essential part of the Chinese healthcare service system. To ensure rural residents’ equal access to such healthcare services, it is necessary to examine the current status of the healthcare system in rural China and formulate corresponding improvement suggestions. This study therefore collects the data from the China Health Statistics Yearbook, the China Health Yearbook and the China Statistical Yearbook between the years 2004 and 2021 to calculate the Gini coefficient (G), health resource density index (HRDI) and Theil index (T) first, and then perform the Mann–Kendall test afterwards to evaluate the equity of healthcare resource allocation comprehensively. This series of analysis helps in drawing the following conclusions: (1) county and county-level city medical and health institutions (CMHIs) show a higher development trend in comparison with township hospitals (THs) and village clinics (VCs); (2) VCs have higher institutional fairness, while for beds and personnel, CMHIs and THs are more fairly positioned; (3) more specifically for CMHIs and THs, personnel allocation is more fair than beds and institution allocations; (4) the density of healthcare resources in the eastern and central regions is higher than that in the western part, while the intra-regional distribution of beds and personnel in the west and central regions is better than that in the eastern region; (5) intra-regional differences are more significant than inter-regional differences and the fairness according to population distribution is higher than that of geographical area allocation. The results of this study provide theoretical basis for further optimizing the allocation of healthcare resources and improving the fairness of healthcare resources allocation from a macro perspective.

Spatial distribution and influencing factors of CDC health resources in China: a study based on panel data from 2016–2021

“…Moreover, the number of permanent residents in the western provinces is small, both of which make for a high CCDC density in the west. Previous studies had shown that the western region has an adequate health workforce ( 27 , 52 , 58 ), which was made a variety of national recruitment programs to attract talented people to work in the west ( 59 ).…”

“…( 26 ). Ao et al used the Gini coefficient, the Theil index and HRDI to evaluate the equity of rural healthcare resources in China ( 27 ). Jian sun used the concentration index to analyze the equity in the distribution of health materials and health human resources ( 28 ).…”

Regional differences, dynamic evolution, and driving factors of high-quality medical resources in China’s ethnic minority areas

“…The horizontal perspective focuses on the fairness of geographicspatial differences in the allocation of MHRs at the provincial level [19]; this includes human health resources [20], regional differences in the supply level of medical resources, and factors influencing regional differences [21]. In addition, scholars have examined inequality in HRA at the city, community, urban, and rural levels [22][23][24][25][26]. The longitudinal perspective centres on the spatiotemporal evolution and sustainable growth of HRA.…”

Regional differences, dynamic evolution, and influencing factors of high-quality medical resources in China’s ethnic minority areas

“…The horizontal perspective focuses on the fairness of geographic-spatial differences in the allocation of MHRs at the provincial level [19]; this includes human health resources [20], regional differences in the supply level of medical resources, and factors in uencing regional differences [21]. In addition, scholars have examined inequality in HRA at the city, community, urban, and rural levels [22][23][24][25][26]. The longitudinal perspective centres on the spatiotemporal evolution and sustainable growth of HRA.…”