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.
Highlights
Attaining the perfect balance of health care resources is probably impracticable; it is possible to achieve improvements in the distribution of these resources
Overview of health resources in Mongolia Mongolia is a land-locked country with a population of three million, 54.3% of whom reside in rural areas
The urban area in the study had the highest numbers of physicians (42.4) and hospital beds (77.6), but one rural province, namely Gobi-Altai, had the highest number of nurses (44.3) per 10 000 population, on average
Summary
Attaining the perfect balance of health care resources is probably impracticable; it is possible to achieve improvements in the distribution of these resources. The aim of this study was to compare the distributions of health care resources in urban, suburban, and rural areas of Mongolia. Human resources are the major building blocks of health systems [1, 2], and all health care is eventually delivered by and to people [3]. A clear picture of the allocation of physical and human resources (especially by area), the proportionate distribution of such resources, and timely revision enable the achievement of better health outcomes and health care accessibility for all [4]. Ulaanbaatar consists of nine districts, which are further divided into 152 sub-districts (khoroos). The 329 sub-provinces are further divided into 1613 communes (baghs) [5]
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