Geographic distribution of hospital beds throughout China: a county-level econometric analysis.

Jay Pan,David Shallcross

doi:10.1186/s12939-016-0467-9

Abstract

BackgroundGeographical distribution of healthcare resources is an important dimension of healthcare access. Little work has been published on healthcare resource allocation patterns in China, despite public equity concerns.MethodsUsing national data from 2043 counties, this paper investigates the geographic distribution of hospital beds at the county level in China. We performed Gini coefficient analysis to measure inequalities and ordinary least squares regression with fixed provincial effects and additional spatial specifications to assess key determinants.ResultsWe found that provinces in west China have the least equitable resource distribution. We also found that the distribution of hospital beds is highly spatially clustered. Finally, we found that both county-level savings and government revenue show a strong positive relationship with county level hospital bed density.ConclusionsWe argue for more widespread use of disaggregated, geographical data in health policy-making in China to support the rational allocation of healthcare resources, thus promoting efficiency and equity.

Highlights

Geographical distribution of healthcare resources is an important dimension of healthcare access
Healthcare access is recognized as a fundamental human right [1], and the geographic distribution of a healthcare delivery system is an important component of healthcare access [2]
The purpose of this study is, first, to describe inequities in the county level geographical distribution of hospital beds in China, and, second, to identify the determinants of hospital bed density at the county level in order to contribute to evidence-informed policy in China

Summary

Introduction

Geographical distribution of healthcare resources is an important dimension of healthcare access. Little work has been published on healthcare resource allocation patterns in China, despite public equity concerns. Methods: Using national data from 2043 counties, this paper investigates the geographic distribution of hospital beds at the county level in China. Conclusions: We argue for more widespread use of disaggregated, geographical data in health policy-making in China to support the rational allocation of healthcare resources, promoting efficiency and equity. Equitable geographic distribution of healthcare resources is believed to improve both health system quality [3,4,5,6,7,8], and economic efficiency [9]. Given the importance of both the absolute level and the relative distribution of healthcare resources, there is a growing literature aimed at understanding healthcare resource allocation patterns [5, 10,11,12]. Analysis of healthcare resource allocation would help to evaluate the impact of China’s health system reforms

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