Distribution of health care resources in Mongolia using the Gini coefficient

Abstract

BackgroundAttaining the perfect balance of health care resources is probably impracticable; however, it is possible to achieve improvements in the distribution of these resources. In terms of the distribution of health resources, equal access to these resources would make health services available to all people. The aim of this study was to compare the distributions of health care resources in urban, suburban, and rural areas of Mongolia.MethodsWe compared urban and rural areas using the Mann–Whitney U test and further investigated the distribution equality of physicians, nurses, and hospital beds throughout Mongolia using the Gini coefficient—a common measure of distribution derived from the Lorenz curve. Two indicators were calculated: the distribution per 10 000 population and the distribution per 1000 km2 area.ResultsUrban and rural areas were significantly different only in the distribution of physicians per population. However, in terms of the distribution per area, there were statistical differences in physicians, nurses, and hospital beds. We also found that distributions per population unit were equal, with Gini coefficients for physicians, nurses, and hospital beds of 0.18, 0.07, and 0.06, respectively. Distributions per area unit were highly unequal, with Gini coefficients for physicians, nurses, and hospital beds of 0.74, 0.67, and 0.69, respectively.ConclusionsAlthough the distributions of health care resources per population were adequate for the population size, a striking difference was found in terms of the distributions per geographical area. Because of the nomadic lifestyle of rural and remote populations in Mongolia, geographical imbalances need to be taken into consideration when formulating policy, rather than simply increasing the number of health care resources.

Inequality in the Distribution of Healthcare Human Resources in Poland

“…These studies show that many different countries suffer from the inequities in distribution of healthcare human resources [51]. Also, these studies indicated that country-specific lifestyle and culture should be taken into account when analysing equity in the distribution and formulation of healthcare human resources strategies.…”

“…In order to examine the distribution of healthcare resources against population size and geographic size in Poland, the Gini coefficient calculated based on the Lorenz Curve was engaged, because it is recognized as one of the most common measure of distribution and also as one of the superior tools for measuring inequity [44][45][46][48][49][50][51][52][53][54][55][57][58][59][60][61][62][63][64][65]108,109]. The Gini coefficient was developed by the Italian Statistician Corrado Gini [110] as a summary measure of income inequality in society [111].…”

“…The problem of district inequities to access to healthcare human resources has been also identified in India [50]. Then, Erdenee et al (2017) found that, in Mongolia, the distribution of healthcare human resources was adequate for the population size although a striking difference was found in case of the geographical distribution. However, they also concluded that, when formulating policy, it is necessary to take into account such features, in Mongolia, for example, as the nomadic lifestyle of rural and also remote populations.…”

“…However, they also concluded that, when formulating policy, it is necessary to take into account such features, in Mongolia, for example, as the nomadic lifestyle of rural and also remote populations. Therefore, it is important to consider such geographical imbalances, rather than simply increasing the number of healthcare resources [51]. Then also, inequities were found in distribution of different types of healthcare human resources in all Iran by Rabbanikhah et al [52] and Mobaraki et al [53] as well as in same only Teheran by Sefiddashti et al [54].…”

Inequality Analysis of Pharmacist Distribution in Iran

“…Various indices such as Gini Coe cient, Atkinson Index and Theil Index (21)(22)(23) are used to measure the equality in access to health services. Gini coe cient is more commonly used in health studies among different countries (24)(25)(26)(27)(28)(29)(30), which is de ned by Lorenz Curve. This index was designed by the Italian statistician and sociologist, Corrado Gini, and was initially used to measure inequality and distribution of wealth and income among population (31).…”