&lt;p&gt;Equity of health workforce distribution in Thailand: an implication of concentration index&lt;/p&gt;

Witthayapipopsakul, Woranan; Cetthakrikul, Nisachol; Suphanchaimat, Rapeepong; Noree, Thinakorn; Sawaengdee, Krisada

doi:10.2147/rmhp.s181174

Cited by 30 publications

(39 citation statements)

References 31 publications

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“…The comparison between the two groups was based on the medium Mann–Whitney U rank sum test, and the comparison between multiple groups was based on the Kruskal–Wallis H rank sum test. For evaluating the distribution and equity of residents’ prevalence of diseases in the two weeks prior to the survey, prevalence of chronic diseases, medical treatment rate in the two weeks prior to the survey, and annual hospitalisation rate in the last year for different income groups, the concentration curve and concentration index (CI) were used for demonstration and calculation [ 39 ]. The value of CI was determined as (−1, 1).…”

Section: Methodsmentioning

confidence: 99%

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Zheng

et al. 2021

IJERPH

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Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies.

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Section: Methodsmentioning

confidence: 99%

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Zheng

et al. 2021

IJERPH

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“…For example, we found that U5MR of 15 deaths/1000 births across Brazil is associated with an approximate workforce level of 5 paediatric surgeons, 200 surgeons, 100 anaesthesiologists or 700 nurses/100 000 children. Geospatial analyses has help guide health workforce expansion in Thailand,24 as well as in some countries in sub-Saharan Africa 25. However, we caution that the workforce associations in Brazil may not be applicable to other countries.…”

Section: Discussionmentioning

confidence: 96%

Towards defining the surgical workforce for children: a geospatial analysis in Brazil

et al. 2020

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ObjectivesThe optimal size of the health workforce for children’s surgical care around the world remains poorly defined. The goal of this study was to characterise the surgical workforce for children across Brazil, and to identify associations between the surgical workforce and measures of childhood health.DesignThis study is an ecological, cross-sectional analysis using data from the Brazil public health system (Sistema Único de Saúde).Settings and participantsWe collected data on the surgical workforce (paediatric surgeons, general surgeons, anaesthesiologists and nursing staff), perioperative mortality rate (POMR) and under-5 mortality rate (U5MR) across Brazil for 2015.Primary and secondary outcome measuresWe performed descriptive analyses, and identified associations between the workforce and U5MR using geospatial analysis (Getis-Ord-Gi analysis, spatial cluster analysis and linear regression models).FindingsThere were 39 926 general surgeons, 856 paediatric surgeons, 13 243 anaesthesiologists and 103 793 nurses across Brazil in 2015. The U5MR ranged from 11 to 26 deaths/1000 live births and the POMR ranged from 0.11–0.17 deaths/100 000 children across the country. The surgical workforce is inequitably distributed across the country, with the wealthier South and Southeast regions having a higher workforce density as well as lower U5MR than the poorer North and Northeast regions. Using linear regression, we found an inverse relationship between the surgical workforce density and U5MR. An U5MR of 15 deaths/1000 births across Brazil is associated with a workforce level of 5 paediatric surgeons, 200 surgeons, 100 anaesthesiologists or 700 nurses/100 000 children.ConclusionsWe found wide disparities in the surgical workforce and childhood mortality across Brazil, with both directly related to socioeconomic status. Areas of increased surgical workforce are associated with lower U5MR. Strategic investment in the surgical workforce may be required to attain optimal health outcomes for children in Brazil, particularly in rural regions.

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“…Because the number of ambulatory visits and the number of physicians in secondary/tertiary hospitals in each province is approximately twice as those in community hospitals, we distributed questionnaires to physicians from community hospitals and secondary/tertiary hospitals with a ratio of 2:1 corresponding to the number of ambulatory visits and the number of physicians in each hospital level. 7,8 To identify patients' barriers to HCC surveillance, patients were divided into 2 groups, optimal and suboptimal surveillance groups. Optimal patients were de ned as having surveillance during the past two years that followed the guidelines, while suboptimal patients had not received surveillance that met the guidelines.…”

Section: Discussionmentioning

confidence: 99%

Physician-and patient-reported barriers to hepatocellular carcinoma surveillance: a nationwide survey

Teerasarntipan

Sritunyarat

Prathyajuta

et al. 2021

Preprint

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Background Hepatocellular carcinoma (HCC) surveillance rates are suboptimal. We aimed to identify HCC surveillance barriers from both physician and patient perspectives and assess the effectiveness of physician education using social networks. Methods A nationwide survey with 513 physicians and another single-center survey with 315 HCC-risk patients were conducted. Regression analysis was used to identify surveillance barriers. We educated 143 physicians by sending brief notes on HCC surveillance guidelines via social networks and re-evaluated their knowledge at 60 days using paired T-test.Results Surveys showed 458 (86.3%), 254 (47.8%) and 225 (42.4%) physicians recommended surveillance in patients with cirrhosis, at-risk HBV and HCV infection, respectively. Only 228 (42.9%) and 241 (38.0%) respondents adhered to recommended surveillance tools and interval, respectively. The main surveillance barriers among physicians were the lack of knowledge and resource limitations. The lack of a doctor’s prescription was identified as main barrier by patients (relative risk 1.4, 95%CI 1.1-1.8, p=0.024). Social networks education enhanced physicians’ knowledge pre-and post-education scores for guideline awareness: (63.0%vs.84.3%, p<0.001) and surveillance indication (40.0%vs.63.0%, p=0.001). Conclusions Physicians’ knowledge gap was primary barrier for adherence to HCC surveillance protocols. Brief education via social networks showed effectiveness at increasing knowledge of HCC surveillance with medical residents.Clinical trial registry: This study was registered to the Thai clinical trial registry (TCTR number 20210127006). Registered 22 July 2021- Retrospectively registered. http://www.clinicaltrials.in.th/

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<p>Equity of health workforce distribution in Thailand: an implication of concentration index</p>

Cited by 30 publications

References 31 publications

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Towards defining the surgical workforce for children: a geospatial analysis in Brazil

Physician-and patient-reported barriers to hepatocellular carcinoma surveillance: a nationwide survey

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