Inequality trends in the demographic and geographic distribution of health care professionals in China: Data from 2002 to 2016

Abstract

SummaryChina has long been negatively affected by a shortage and maldistribution of health workers. This study aimed to examine the national and regional trends in the demographic and geographic distribution inequality of health care professionals in China from 2002 to 2016. Based on data from the China Health and Family Planning Statistical and China Statistical Yearbooks, we calculated the Gini coefficient and the Theil T and Theil L indices based on the number of health care professionals per capita and per geographic area to measure the inequalities in their demographic and geographic distribution, respectively. The contributions by intra‐regional and inter‐regional differences on total inequality were explored within and among East, Central, and West China via Theil index decomposition. We found that the national demographic distribution of health care professionals maintained in an absolute equality level, and the inequality indices decreased gradually, whereas the corresponding geographic inequalities were severe and presented a worsening trend. Compared with nurses, physicians not only maintained higher densities but also maintained a more equal distribution. Intra‐regional disparities within the east, central, and western regions were the main cause for overall demographic inequality, whereas both intra‐regional and inter‐regional disparities significantly contributed to overall geographic inequality. To conclude, the distribution equality of health care professionals by population was satisfactory, whereas the corresponding distribution inequality by area was severe. Different types of distribution inequality of health care professionals existed regionally and nationally despite their increasing quantities and densities. Factors beyond population size should be considered when the government introduces health workforce allocation policies.

Distribution Analysis of Doctors in Indonesia

“…Disparities in the distribution of physicians in the Indian region and China were also found to be in line with the widening of the Gini index (Singh, 2019) (Yang, Yin and Wang, 2019) (Wu and Yang, 2019).…”

Forecasting maldistribution of human resources for healthcare and patients in Japan: a utilization-based approach

“…Many countries are interested in the relationship between demographic change and medical needs. Several studies have analyzed, in particular, the relationship with the placement of professions, especially since the development of human resources takes long time [14, 15, 33]. In any country, demographic trend differ from transition of healthcare workforce, these trend vary by area and by disease.…”

Inequality in the Distribution of Healthcare Human Resources in Poland

“…There is a bunch of research in the context of China healthcare sector. Even the increase of different types of healthcare human resources took place with different levels of inequity in the distribution of them found in China by Li et al [56], Wu et al [57] Lu and Zeng [58], Zhang et al [59], and Jin et al [60]. Also in Japan, Kobayashi and Takaki [61] did not found any improvement in the equality in physician distribution as well as Toyabe [62].…”

“…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].…”