Inequality in distribution of physician and general practitioner in Sistan and Baluchestan province, Iran (2009-2017)

Shahraki, Mahdi; Ghaderi, Simin

doi:10.29252/payesh.19.2.177

Cited by 7 publications

(13 citation statements)

References 7 publications

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“…Also, our findings were consistent with some other studies 49,50 conducted in Iran. Nevertheless, a study 25 carried out in Iran showed that the distribution of GPs in Sistan and Baluchestan Province was better off than that of our estimate for South Khorasan Province.…”

Section: Discussioncontrasting

confidence: 93%

“…23 For this reason, it is necessary to evaluate the access and distribution of health services as well as the human resources in order to develop and implement comprehensive programs aimed at addressing the identified problems. 16 On one hand, several studies [24][25][26] emphasized the distribution of resources within the same province rather than between various provinces, and this was due to the negative impact of inequality on efficiency and public health indicators. On the other hand, some other studies highlighted the attractiveness of industrial areas and tourist destinations for healthcare professionals, as mentioned in Kazemi et al 27 Hence, particular attention should be paid to the intraprovincial distribution of human resources in health care, especially in border provinces such as South Khorasan, mainly because of their limited population and paucity of resources, which in turn adversely affects their appeal to healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

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

Manesh

Zafarghandi

Merati

et al. 2021

Proceedings of Singapore Healthcare

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Background Inequitable distribution of human resources in healthcare is one of the main obstacles to improve any health system. This study aimed to evaluate inequalities in the distribution of human resources in healthcare in South Khorasan Province, Iran. Methods We have investigated three types of health staff (i.e. nurses, general practitioners, and specialists) from 2013 to 2018. Data were collected from the annual reports of the Statistical Centre of Iran. The Gini coefficient and time trend regression were applied to measure the inequality. Results The distribution of specialists and general practitioners were the highest and lowest inequality, respectively. Inequalities in the distribution of nurses and specialists have decreased from 2013 to 2018, while the Gini coefficients of the general practitioners have increased from 0.31 to 0.38. According to the regression analysis, inequality in the distribution of nurses and specialists was decreasing over the time; however, the decline was only significant for specialists. While the coefficient B for general practitioners is positive, this indicates raised inequality, but the observed increase was not significant. Conclusions This study revealed that Iran, similar to several other low- and middle-income countries, is with faced the challenge of inequitable distribution of human resources in healthcare, which in turn indicates the necessity of reforms at national and regional levels to address inequalities in the distribution of healthcare human resources, particularly in South Khorasan Province. Hence, the main policy recommendation is to focus on continuous monitoring and evaluation of resource allocation in South Khorasan Province to reduce inequalities.

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Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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

Manesh

Zafarghandi

Merati

et al. 2021

Proceedings of Singapore Healthcare

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“…The lowest number was in Avaj (1 person). After the implementation of the HTP, the number of infectious disease specialists (28), gynecologists (22), anesthesiologists (16), neurologists (8), radiologists (5) and pathologists (7), otolaryngologists (6) and emergency medicine specialists (n = 5) increased. A downward trend was observed in pediatric infectious diseases subspecialist (n = 1) and pediatric surgery (n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Ghaderi et al showed that according to the Hirschman-Herfindahl index (HHI), inequality in the distribution of GPs in Sistan and Baluchestan, a Province in soth of Iran, in 2020 has decreased. However, inequality in the distribution of specialists remains at a high level [ 8 ]. Sugawara et al studied psychiatrists' distribution for patients having mental illness via a utilization-based approach.…”

Section: Introductionmentioning

confidence: 99%

Measuring inequality in the distribution of health human resources using the Hirschman-Herfindahl index: a case study of Qazvin Province

Nasiri

Amerzadeh

Moosavi

et al. 2022

BMC Health Serv Res

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Background Achieving equity in the distribution of health services is one major goal in the health system. This study aimed to determine equality in distributing health human resources (physicians) in the Qazvin University of Medical Sciences before and after the Health Transformation Plan (HTP) based on the Hirschman-Herfindahl index (HHI). Methods In this descriptive-analytical study, the statistical population was general practitioners (GPs), specialists and subspecialists in the Qazvin University of Medical Sciences from 2011-to 2017. We extracted demographic statistics of the cities from the Statistical Center of Iran. Physicians’ statistics were obtained from the Curative Affairs Deputy at the Qazvin University of Medical Sciences. We assessed inequality using the HHI. Results The highest number of GPs was in 2014, and specialists and subspecialists were in 2017. The lowest number of GPs, specialists, and subspecialists were in 2016, 2011 and 2015. The HHI for GPs in 2011–2017 was between 4300 and 5200. The lowest concentration for specialists before the HTP plan was the cardiologist with 3300, and after the HTP, the internal specialist with 3900. Also, the numerical value of this index for all subspecialty physicians after the HTP was 10,000, the highest level of concentration. Conclusion The values obtained from the HHI index indicate the high concentration and disproportionate and inequitable distribution of human resources in the health sector in this province. The number of specialists in some cities is still much less than acceptable, and some cities even have shortcomings in the critical specialists.

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“…It quantifies the proportion of health resources that need to be redistributed, essentially the amount that must be transferred from the more advantaged segments of the population to the less affluent ones to achieve complete equality in resource distribution (28). This index ranges from zero (indicating perfectly distributed resources) to one hundred percent (signifying the most inequitably distributed resources) (29). Graphically, it is represented by the maximal vertical distance between the Lorenz curve and the 45-degree line.…”

Section: Robin Hood Indexmentioning

confidence: 99%

Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province

Rezaee,

Azmal,

Lotfi

et al. 2024

Shiraz E-Med J

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Background: Equity in access to health resources is a fundamental goal of health systems worldwide. Objectives: This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province. Methods: This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18. Results: The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels. Conclusions: Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.

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Inequality in distribution of physician and general practitioner in Sistan and Baluchestan province, Iran (2009-2017)

Cited by 7 publications

References 7 publications

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

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

Measuring inequality in the distribution of health human resources using the Hirschman-Herfindahl index: a case study of Qazvin Province

Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province

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