Respiratory healthcare resource allocation in rural hospitals in Hunan, China: a cross-sectional study

Background Rural hospitals in China provide respiratory health service for about 600 million people, but the current situation of respiratory healthcare resource allocation in rural hospitals has never been reported.Methods In the present study, we designed a survey questionnaire, and collected information from 48 rural hospitals in Hunan Province, focusing on their respiratory medicine specialty, basic facilities and equipment, clinical staffing and available medical techniques.Results The results showed that 58.3% of rural hospitals established an independent department of respiratory medicine, 50% provided specialized outpatient service, and 12.5% had an independent respiratory intensive care unit. Among these hospitals, 72.9% were equipped with pulmonary function test laboratories, 54.2% had bronchoscopy rooms, 64.6% had non-invasive ventilators, 43.8% had invasive ventilators, while less than 15% had set up sleep laboratories and atomization therapeutic rooms. The overall physician-to-bed ratio and nurse-to-bed ratio were 1:11.1 and 1:13.6, respectively. Mechanical ventilation, diagnostic bronchoscopy, therapeutic bronchoscopy, thoracoscopy, percutaneous lung biopsy, transbronchial needle aspiration and bronchial artery embolism were applicable in 66.7%, 47.9%, 6.3%, 18.8%, 20.8%, 8.3% and 8.3% of rural hospitals, respectively. Rural hospitals without an independent department of respiratory medicine showed significant disadvantages in facilities and equipment, clinical staffing and medical techniques over the other hospitals.Conclusions Respiratory healthcare system in rural areas of China are facing great challenges, including a serious shortage of basic facilities and equipment, necessary medical techniques and high-quality workforce. Besides, disparity of respiratory healthcare resources has been increasing among rural hospitals. More financial and political support from the government are needed to improve the access to and the quality of respiratory health service for rural residents.