The allocation and fairness of health human resources in Chinese maternal and child health care institutions: a nationwide longitudinal study

Ma, Yuan; Xiao, Ping; Liu, Yu; Ni, Henfan; Huang, Shiyao; Wang, Meixian; Huang, Yuxiang; Li, Li; Yang, Linlin; Tan, Chunjian; Zhong, Zhigang

doi:10.1186/s12913-023-09076-5

Cited by 8 publications

(5 citation statements)

References 31 publications

(36 reference statements)

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“…The calculation of the 95% confidence interval (CI) was based on the assumption that the data followed a normal distribution within each specific region; national estimates of 95% CI were calculated using the svymean and confint functions of survey package. 14 Regional disparity in CSC and eCSC was analyzed using Pearson correlation analysis that included the following factors: a) healthcare resource density index, 15 e.g., 13 number of registered ophthalmologists (in total/with senior title/with bachelor degree) per million, 16,17 b) level of medical resources allocation, e.g., number of registered doctors, health expenditure per capita, top-tier hospitals per capita , 13 c) traditional socio-economic indices, e.g., GDP per capita, education coverage, socio-demographic index 18 and birth rate. 13 Logistic regression models were employed to evaluate the association between CSC, eCSC and gender, adjusting for age.…”

Section: Discussionmentioning

confidence: 99%

Effective cataract surgical coverage in China: results from the China National Eye Health Study (CNEHS)

Li,

Cao,

et al. 2024

Preprint

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PurposeThe 74th World Health Assembly endorsed a global target for 30% increase in effective cataract surgery coverage (eCSC) from 2020 to 2030. The current study was conducted to help monitoring the progress in the next decade in China.DesignA cross-sectional multi-center study, the China National Eye Health Survey (CNEHS), was conducted from 2021 to 2022 and covered 562 communities/villages from 12 representative provinces in China.MethodsThis study is based on participants who were at least 50 years of years in the CNEHS. eCSC estimates the proportion of individuals with operated cataract achieving postoperative visual acuity ≥6/18 out of the total population including both operated and operable cataract cases. Both the CSC and eCSC were adjusted for age and sex.ResultsA total of 45,051 participants were included in the analysis. The standardized incidence of vision impairment and blindness (best-corrected visual acuity in the better eye <6/18) was 4.4% (95% CI, 4.2%-4.6%). Cataracts accounted for 52.7% of these cases. The weighted rates of CSC and eCSC were 57.2% (95% CI, 47.6%-66.8%) and 38.7% (95% CI, 31.7%-45.6%), respectively. Contributing factors to the quality gap(difference between CSC and eCSC) included concurrent ocular diseases (62.2%) and complications relevant to surgery. CSC increased by 38.9% and eCSC by 26.1% over the decade. Both CSC and eCSC varied substantially across the 12 provinces (range: 41.2%-87.3% for CSC; 16.7%-71.0% for eCSC). Pearson correlation analysis indicated that regional disparities were primarily explained by the level of medical resource allocation, particularly the number of physicians or ophthalmologists per unit population (r=0.6, p=0.03).ConclusionDuring the 2021-2022 period, CSC and eCSC rates in China were 57.2% and 38.7%, respectively. Regional disparity in cataract coverage were observed and correlated with the level of medical resources allocation.WHAT IS ALREADY KNOWN ON THIS TOPICThe latest national epidemiological data on cataract surgical coverage in China dates back to 2014 and contains limited information.WHAT THIS STUDY ADDSBetween 2021 and 2022, the rates of CSC and eCSC in China were 57.2% and 38.7% at the 6/18 threshold, respectively. Comparing this with historical data reveals a significant improvement, with eCSC increasing by 26.1% over the past decade. However, there remains a notable quality gap, largely due to concurrent ocular diseases (62.2%), which should not be included in the eCSC measure. Additionally, substantial regional disparities were identified, with eCSC rates varying from 16.7% to 71.0% across the 12 surveyed provinces/municipalities. These disparities are primarily linked to the distribution of medical resources per capita rather than economic status.HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE, OR POLICYDespite significant improvements over the past decade, CSC and eCSC rates in China remain lower than those reported in most other countries. To address this, the government is urged to allocate more medical resources to less developed regions. Furthermore, the definition of eCSC should be revisited to exclude biases from concurrent ocular diseases.

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Section: Discussionmentioning

confidence: 99%

Effective cataract surgical coverage in China: results from the China National Eye Health Study (CNEHS)

Li,

Cao,

et al. 2024

Preprint

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“…Variations in methodology may be related to a hesitancy among Chinese NIP providers to administer vaccinations to children with medical conditions (11), which may be influenced by unfamiliarity with certain medical conditions, insufficient knowledge regarding vaccine safety and efficacy in specific medical cases, and an absence of official, detailed guidelines for particular conditions (12). Although vaccination evaluation clinics positively impact the intentions of concerned parents to vaccinate their children (5), it is crucial to comprehend and overcome the barriers preventing NIP providers from recommending and administering vaccinations to children with medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Survey on Immunization Services for Children with Medical Conditions — China, 2022

Huo¹,

Song²,

Li³

et al. 2023

China CDC Weekly

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What is already known about this topic?Children with medical conditions frequently experience under-immunization.Ensuring high-quality immunization services is crucial for enhancing vaccination coverage levels; nevertheless, the state of immunization service provision for children with medical conditions in China remains unclear. What is added by this report?Immunization support for children with medical conditions in China demonstrates considerable variability and may be inadequate. Primary obstacles to the provision of immunization services include an absence of comprehensive vaccination recommendations and assessment guidelines for specific medical conditions, as well as inconsistencies among vaccine recommendations, package inserts, and expert consensus statements pertaining to the vaccination of children with medical conditions. What are the implications for public health practice?The examination of provincial practices in providing immunization services for children with medical conditions, as well as understanding the barriers faced by National Immunization Program providers in administering vaccinations, can contribute to the improvement of immunization services for this population in China.

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“…The HRDI integrates the influence of population and geographic area factors on the allocation of health resources and is highly practical for sparsely populated regions [ 14 ]. The formula is.…”

Section: Methodsmentioning

confidence: 99%

Equity and efficiency of health resource allocation in township health centers in Sichuan Province, China

Zhou

2024

PLoS ONE

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Objective To analyze the equity and efficiency of health resource allocation in township health centers in Sichuan Province, and to provide a scientific basis for promoting the development of township health centers in Sichuan Province, China. Methods The Lorenz curve, Gini coefficient and health resource density index were used to analyze the equity of health resource allocation in township health centers in Sichuan Province from 2017 to 2021, and data envelopment analysis(DEA) was used to analyze the efficiency of health resource allocation in township health centers in Sichuan Province from 2017 to 2021. Results The Gini coefficient of health resources of township health centers in Sichuan Province is below 0.2 by population in addition to the number of beds in 2020–2021 and practicing (assistant) physicians in 2021, and the Gini coefficient of health resources of township health centers in Sichuan Province is above 0.6 by geography. The Lorentz curve of health resources of township health centers in Sichuan Province is closer to the equity line by population allocation and further from the equity line by geographical allocation. The average level of township health centers in Sichuan Province is used as the standard to calculate the health resource density standard index(W) of each region, the Ws of Panzhihua, Ganzi, Aba and Liangshan are less than 1, and the Ws of Ziyang, Neijiang, Deyang and Meishan are greater than 1. The overall efficiency of township health centers in Sichuan Province in 2017 and 2021 is 1, and the DEA is relatively effective. The overall efficiency of township health centers in Sichuan Province in 2018 and 2019 is not 1, and the DEA is relatively ineffective. The overall efficiency of all health resources in Mianyang and Ziyang is 1, and the DEA is relatively effective. The overall efficiency of all health resources in Suining, Neijiang, Yibin, Aba and Ganzi is not 1, and the DEA is relatively ineffective. Conclusion The equity of health resource allocation by population is better than that by geography in township health centers in Sichuan Province. Combining population and geographical factors, the health resource allocation of Panzhihua, Ganzi, Aba and Liangshan is lower than the average level of Sichuan Province. The efficiency of health resource allocation in township health centers in Sichuan Province is low.

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The allocation and fairness of health human resources in Chinese maternal and child health care institutions: a nationwide longitudinal study

Cited by 8 publications

References 31 publications

Effective cataract surgical coverage in China: results from the China National Eye Health Study (CNEHS)

Effective cataract surgical coverage in China: results from the China National Eye Health Study (CNEHS)

Survey on Immunization Services for Children with Medical Conditions — China, 2022

Equity and efficiency of health resource allocation in township health centers in Sichuan Province, China

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