Abstract
Background: In this study, we aimed to estimate the equity and efficiency of traditional Chinese medicine (TCM) health resource allocation, utilization, and trend in mainland China from 2013 to 2017.Methods: The data were downloaded from the China Health Statistical Yearbook (2014–2018) and the China Statistical Yearbook (2018). The equity of TCM health resource allocation was evaluated through the Lorenz curve, Gini coefficient (G), and Theil index (T) based on population size and geographical area. The efficiency and productivity of TCM health resource utilization were assessed using the data envelopment analysis-based Malmquist productivity index.Results: TCM health resource had an increasing trend every year. The equity allocated by population (G ranging from 0.1 to 0.3) was better than that by geographic region (G > 0.5). T in the intra-groups was higher than those in the inter-groups. The equity of TCM resource allocation was the middle region > eastern region > western region. Most provinces (29 out of 31) had negative productivity changes, suggesting deterioration in productivity. Moreover, the middle region with higher scale sizes had more redundant inputs than the other two regions. However, the low technological development (all technical values <1) might hinder productive progress.Conclusion: The equity of TCM health allocated by the population was better than that by the geographic region. The intra-regional difference was the main reason for inequity sources. Productivities in more than 97% of provinces are inefficient. The frequency distribution of scale efficiency (score > 1) had increased since 2015. However, the frequency distribution of technical change (score > 1) decreased every year. The slow technological progress and low scale size might be the main reasons for low productivity.
Highlights
Health resource allocation has been a global issue in the human health service market
The results indicated that the beds and health staff were more equitable than the institutions allocated by the population size
We found that the intra-group difference was the main reason for the inequity of traditional Chinese medicine (TCM) health resource allocation
Summary
Health resource allocation has been a global issue in the human health service market. Since the 1980s, with the implementation of market-oriented reform in China, the existing health resources and services are struggling to meet the needs of rapid economic development and the aging population [2]. In 2009, the Chinese Ministry of Health launched an ambitious healthcare reform program aiming for universal health coverage for all Chinese citizens by 2020 [3]. In the past 10 years, with deepening reforms on health facilities and public hospitals, a zero-price policy of medicine, and full coverage of basic insurance, the ongoing health reform has made great progress [4, 5]. We aimed to estimate the equity and efficiency of traditional Chinese medicine (TCM) health resource allocation, utilization, and trend in mainland China from 2013 to 2017
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