Stratification of Health Professional Education and Its Funding Disparities: Evidence From China During the Period of 1998–2017

Abstract

Background: The finance of health professional education (HPE) is of immense importance for effective and sustainable health systems, yet relevant empirical research was scarce due to the lack of financial data. The study aimed to bridge the gap by presenting the scenario of finance for health professional institutions (HPIs) of different tiers in China and exploring how the stratification of institutions affected their funding disparities.Methods: The study employed data collected from the Ministry of Education in China, and selected the HPIs mainly based on the World Directory of Medical Schools. The funding levels and disparities of China's HPIs during the period (1998–2017) were analyzed with descriptive statistics, and the indicators of funding per institution and funding per student were both considered. The average funding in HPIs was presented by tiers, and the Gini coefficient and Theil index were employed to describe the differences in financing among HPIs over the span.Results: The study found that the number of HPIs has kept growing over the past two decades, with both the funding per institution and the funding per student increasing steadily. Specifically, the average funding per institution of the three tiers increased by 31.5 times, 13.4 times, and 10.5 times separately, with the first-tier universities having an absolute advantage compared to lower tiers. As for the financing disparities among HPIs, the Gini coefficient of the funding per institution maintained to be over 0.5, with the third-tier institutions scoring the highest, while the Gini coefficient of the funding per student all ranged approximately from 0.2 to 0.3. Through the decomposition of the inequalities measured by the Theil index, the share of the between-tier difference in per-institution funding grew from 29.7 in 1998 to 77.9% in 2017.Conclusions: The funding disparities between tiers of HPIs in China gradually became more accentuated, with the top-tier institutions taking up the largest share. Although the stratified development in HPE has posed a challenge to the unified quality assurance of medical personnel training, it may also be regarded as an effective pathway for developing countries like China to achieve stable development in health professional education.

Spatial and Temporal Characterization of Mine Water Inrush Accidents in China, 2014–2022

“…The Thiel index has been widely used in evaluating the fairness of water resource allocation [17], the analysis of the spatial variability of resources [18], the assessment of the differences in the distribution of natural disasters [19], the degree of spatial differentiation of agricultural pollution [20], etc. The Thiel index is decomposable and can be decomposed by intra-regional and inter-regional differences, thus measuring the contribution of intraregional and inter-regional differences to the total differences [21].…”

“…Only three water inrush accidents occurred in the east development region, resulting in fewer injuries and financial losses. The central Currently, China's primary sources of coal supply are the central and west development regions, which may result in more mine water inrush accidents in these regions [20,26]. The northeast, east, and central development regions have more coal resource exploration due to earlier development time, resulting in relatively complete technical systems and production management compared to the west development region [27,28].…”

Direct Health Education Effect on Mandangin Island Public’s Knowledge of The Most Common Diseases in Children

“…This study involved adults, with most of them holding secondary school leaving certificate, which allowed us to provide basic and functional health knowledge that is accurate and directly contribute to health-promoting decisions and behavior 16,17 . We avoided using scientific and complicated words to make the material book easier to understand and feasible 14,18 .…”