Assessing equity in the distribution of hospital beds: evidence from northern Iran

Abstract

Objective: To assess equity in the distribution of hospital beds in northern Iran. Methods: In this cross-sectional study, we investigated the degree of equity by using 2016 census data from 16 cities in Guilan province. The hospital beds include burns, intensive care unit, coronary care unit and neonatal intensive care unit beds. We analysed the general status and explored its distribution equity by using the Theil index. Findings: We found that Rezvanshahr and Masal had no hospital beds. The utilisation gap was positive only in Rasht, as capital of the province. Neonatal intensive care unit beds were only found in Rasht and Lahijan. Rasht was shown to have a positive gap in using burns, intensive care unit and coronary care unit beds, with a negative gap of 14.68 in coronary care unit beds. The other 15 cities did not have such hospital beds. For intensive care unit, coronary care unit and neonatal intensive care unit beds, nearly 8%, 2% and 14% of cities were deprived of being equipped with these hospital beds, respectively. The highest positive gap and the lowest negative gap were attributed to coronary care unit beds. In the province, there were 0.057 burns beds, 0.137 intensive care unit beds, 0.381 coronary care unit beds and 0.72 neonatal intensive care unit beds per 10,000 population (neonatal intensive care unit beds, per 1000 neonates). In 11 out of 16 cities, the number of coronary care unit beds per 10,000 population was higher than the provincial average. The highest inequality in distribution was shown to be for burns beds (0.8), neonatal intensive care unit beds (0.75), intensive care unit beds (0.55) and coronary care unit beds (0.21), respectively. Conclusion: This study revealed high inequalities in the distribution of hospital beds in northern Iran. The local and national policy-makers should design and implement a comprehensive monitoring and evaluation system for tracking and allocating healthcare resources, both qualitatively and quantitatively, which appears to be very necessary to increase the equity in access to healthcare services.

Assessing Equality In Hospital Bed Distribution In North Sumatra Of June 2022

“…Based on the same data, Medan City is the region with the highest number of hospital beds for almost all types of beds, except perinatal beds. This pattern of concentration of health resources in the provincial capital was also found in a study assessing the equality of the distribution of beds in Gilan Province, Iran (Ebrahimzadeh et al, 2019) ICCU/CVCU, 43.43% NICU beds, and 60% PICU beds, 33.31% isolation beds, and 48.30% HCU beds in North Sumatra.The ratio of ordinary beds in the province of North Sumatra as of June 2022 is 1.14 per 1000 population. This ratio of beds per 1000 population is lower than the ratio of national beds, which is 1.49 per 1000 population (Mahendradhata et al, 2017(Mahendradhata et al, , 2021.…”

“…In addition, Indonesia before the pandemic only had 1910 Intensive Care Units (ICU) consisting of 7904 ICU beds. This number of beds results in a ratio of ICU beds in Indonesia of only 2.7 ICU beds per 100,000 population, much lower than the ratio of ICU beds in other ASEAN countries such as Malaysia (3.4 ICU beds per 100,000 population), Thailand (10 .4 ICU beds per 100,000 population), or Singapore (11.4 ICU beds per 100,000 population) (Mahendradhata et al, 2021).Research by Ebrahimzadeh et al (2019) in Northern Iran regarding the distribution of intensive care beds showed that there were 2 regions namely Rezvanshar and Masal which had no intensive care beds at all and only Rasht and Lahijan areas which had neonatal intensive care beds. However, this study did not assess the distribution of hospital beds for usual (non-intensive) care.…”

“…One way to measure equity in access to health is to measure the distribution of hospital beds. Equality in the distribution of hospital beds as a health service resource is rarely measured and researched (Ebrahimzadeh et al, 2019). Failure to collect this information results in an unequal distribution of hospital beds in various regions.At the end of 2019, an outbreak of a respiratory infection occurred in the city of Wuhan, Hubei province, People's Republic of China.…”

Inequality trends in the distribution of healthcare human resources in eastern Iran

“…Due to the unsustainable financial resources of the health sector, international sanctions, and soaring costs, the need for controlling demand for healthcare services and emphasizing self-care and prevention cannot be neglected. 15,20 According to the findings of the present study, despite expanding training capacities in recent decades, the problem of unequal distribution of human resources persists. Therefore, it can be argued that sole expansion of training capacities is not sufficient to improve the access to healthcare human resources or their distribution.…”

“…[10][11][12][13][14][15][16][17][18] In Iran, several studies have examined the distribution of resources and reported serious inequalities. 11,[13][14][15][16][19][20][21] According to Article 29 in the Iranian Constitution, all society's population should enjoy the right to social security and get benefits with respect to retirement, unemployment, old age, workers' compensation, lack of guardianship, destitution, accidents, and demand to healthcare services (either for insured or uninsured). 22 All of these privileges should be governmentally provided using public income and society's contributions.…”