scholarly journals Differences in Regional Distribution and Inequality in Health-Resource Allocation on Institutions, Beds, and Workforce: A Longitudinal Study in Shanghai, China

2020 ◽  
Author(s):  
Enhong Dong ◽  
Xiaoting Sun ◽  
Lufa Zhang ◽  
Minjie Chen ◽  
Hongmei Wang ◽  
...  
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Rural Areas ◽  
Regional Distribution ◽  
Theil Index ◽  
Health Resource ◽  
Average Growth ◽  
Health Care Resources ◽  
Health Resource Allocation ◽  
Inequality In Health

Abstract Background: The distribution of health-care resources is a critical component of health-care access, and equity is a basic principle of health-resource allocation, and foundational to achieving fairness in the provision of health services. China and its local Shanghai’s government has implemented measures to allocate health-care resources with the equity as one of the major goals since 2009.The aim of this study was to analyze differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce in Shanghai over 7 years.Methods: A longitudinal survey using 2010–2016 data, which were collected for analysis. The study was conducted health-resource allocation on institutions, beds, and workforce in Shanghai, China. Five health-resource indicators were used to measure health-resource distribution at the city and district levels. Furthermore, the Theil index was calculated to measure inequality of health-resource allocation.Results: All quantities of health-care resources per 1000 people increased across Shanghai districts from 2010 to 2016. Compared with suburban districts, the central districts had higher ratios on five health-care resource indicators, and faster average growth in the bed and nurse indicator, and slower growth in the institution, technician and doctor indicator. The Theil indices of the technicians, doctors, nurses and beds had higher values than that of institutions every year from 2010 to 2016; furthermore, the Theil indices of the indicators, except for doctors in hospitals, all exhibited downward time trends.Conclusions: Increased health-care resources and reduced inequality of health-resource allocation in Shanghai during the 7 years indicated that the measures taken by the Shanghai government in the new round of healthcare reform in China since 2009 had been successful. Meanwhile there still existed regional difference between urban and rural areas and inequality between institution and workforce, especially doctors.

scholarly journals Differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce: a longitudinal study in China

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Enhong Dong ◽  
Jie Xu ◽  
Xiaoting Sun ◽  
Ting Xu ◽  
Lufa Zhang ◽  
...  
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Time Trends ◽  
Regional Distribution ◽  
Health Care Resource ◽  
Theil Index ◽  
Health Resource ◽  
Health Care Resources ◽  
Health Resource Allocation ◽  
Inequality In Health

Abstract Background The distribution of health-care resources is foundational to achieving fairness and having access to health service. China and its local Shanghai’s government have implemented measures to allocate health-care resources with the equity as one of the major goals since 2009-health-care reform. The aim of this study was to analyze differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce in Shanghai over 7 years. Methods The study was conducted using 2010–2016 data to analyze health-resource allocation on institutions, beds, and workforce in Shanghai, China. The annual growth rate (AGR) was used to evaluate the time trends of health-care resource from 2010 to 2016, and Theil index was calculated to measure inequality of five indicators of health-care resource allocation during this study period. Results All quantities of health-care resources per 1000 people increased across Shanghai districts from 2010 to 2016. Compared with suburban districts, the central districts had higher ratios on five health-care resource indicators, and faster average growth in the bed and nurse indicator. The Theil of the indicators, except for doctors in hospitals, all exhibited downward time trends. Conclusions Regional difference between urban and rural areas and inequality between institution and workforce, especially for doctors, still existed. Some targeted measures including but not limited to income raising, facilitation of transportation conditions, investment of more fiscal funds, enhancement of health-care service provision for rural residents should be fully considered to narrow resource distribution gap between urban and rural districts and mitigate the inequality of health-care resource allocation.

scholarly journals Differences in regional distribution and inequality in health-resource allocation at hospital and primary health centre levels: a longitudinal study in Shanghai, China

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035635
Author(s):  
Enhong Dong ◽  
Shipeng Liu ◽  
Minjie Chen ◽  
Hongmei Wang ◽  
Li-Wu Chen ◽  
...  
Keyword(s):  
Resource Allocation ◽  
Health Centre ◽  
Regional Distribution ◽  
Primary Health Centre ◽  
Theil Index ◽  
Health Resource ◽  
Healthcare Resources ◽  
Health Resource Allocation ◽  
Primary Health ◽  
Inequality In Health

ObjectivesTo analyse differences in regional distribution and inequality in health-resource allocation at the hospital and primary health centre (PHC) levels in Shanghai over 7 years.DesignA longitudinal survey using 2010–2016 data, which were collected for analysis.SettingThe study was conducted at the hospital and PHC levels in Shanghai, China.Outcome measuresTen health-resource indicators were used to measure health-resource distribution at the hospital and PHC levels. In addition, the Theil Index was calculated to measure inequality in health-resource allocation.ResultsAll quantities of healthcare resources per 1000 people in hospitals and PHCs increased across Shanghai districts from 2010 to 2016. Relative to suburban districts, the central districts had higher ratios, both in terms of doctors and equipment, and had faster growth in the doctor indicator and slower growth in the equipment indicator in hospitals and PHCs. The Theil Indices of all health-resource allocation in hospitals had higher values compared with those in PHCs every year from 2010 to 2016; furthermore, the Theil Indices of the indicators, except for technicians and doctors in hospitals, all exhibited downward time trends in hospitals and PHCs.ConclusionsIncreased healthcare resources and reduced inequality of health-resource allocation in Shanghai during the 7 years indicated that measures taken by the Shanghai government to deepen the new round of healthcare reform in China since 2009 had been successful. Meanwhile there still existed regional difference between urban and rural areas and inequality across different medical institutions. To solve these problems, we prescribe increased wages, improved working conditions, and more open access to career development for doctors and nurses; reduced investments in redundant equipment in hospitals; and other incentives for balancing the health workforce between hospitals and PHCs.

Mental health policy in Greece: Implications into practice in the era of economic crisis

2011 ◽  
Vol 26 (S2) ◽  
pp. 539-539 ◽  
Author(s):  
I. Grammatikopoulos ◽  
S. Koupidis ◽  
E. Petelos ◽  
P. Theodorakis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Policy ◽  
Mental Health Care ◽  
Economic Crisis ◽  
Rural Areas ◽  
Care Delivery ◽  
Mental Health Policy ◽  
Regional Distribution ◽  
Health Care Facilities

IntroductionBudgets allocated for mental health make up a relatively small proportion of total health expenditures, although there is an increasing burden of mental disorders.ObjectivesTo review the mental health situation in Greece with regards to mental health policy through review of relevant literature.AimsTo explore the basic implications of the economic crisis from a health policy perspective, reporting constraints and opportunities.MethodsA narrative review in PubMed/Medline along with a hand search in selected Greek biomedical journals was undertaken, relevant to mental health policy.ResultsGreece is among the OECD countries with high health expenditure as a percentage of Gross Domestic Product (9.7% of GDP in 2008) but it doesn’t have a specified budget for mental health and is mostly depended in out-of-pocket expenditure (48%). The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management and poor incentives in the public sector. The lack of cost-effectiveness and the informal payments comprise a major source of inequity and inefficiency. Uneven regional distribution of psychiatrists exists and rural areas are mostly uncovered by mental health care facilities, as well as extramural mental health units and rehabilitation places, despite the current reorganization of the whole mental health care delivery system.ConclusionsThe core problem with mental health services in Greece is the shrinking budget with poor financial administration consistent with inadequate implementation of mental health policy. A clear authority with defined responsibility for overall mental health policy and budgetary matters is needed.

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