Inequality trends of health workforce in different stages of medical system reform (1985-2011) in China.

Kaiyuan Zhou,Duolao Wang,Min Yu,Yi Ding,Xinyi Zhang,Zhou Lu

doi:10.1186/s12960-015-0089-0

Abstract

IntroductionThe aim of this study was to identify whether policies in different stages of medical system reform had been effective in decreasing inequalities and increasing the density of health workers in rural areas in China between 1985 and 2011.MethodsWith data from China Health Statistics Yearbooks from 2004 to 2012, we measured the Gini coefficient and the Theil L index across the urban and rural areas from 1985 to 2011 to investigate changes in inequalities in the distributions of health workers, doctors, and nurses by states, regions, and urban-rural stratum and account for the sources of inequalities.ResultsWe found that the overall inequalities in the distribution of health workers decreased to the lowest in 2000, then increased gently until 2011. Nurses were the most unequally distributed between urban-rural districts among health workers. Most of the overall inequalities in the distribution of health workers across regions were due to inequalities within the rural-urban stratum.Discussions and conclusionsDifferent policies and interventions in different stages would result in important changes in inequality in the distribution of the health workforce. It was also influenced by other system reforms, like the urbanization, education, and employment reforms in China. The results are useful for the Chinese government to decide how to narrow the gap of the health workforce and meet its citizens’ health needs to the maximum extent.

Highlights

The aim of this study was to identify whether policies in different stages of medical system reform had been effective in decreasing inequalities and increasing the density of health workers in rural areas in China between 1985 and 2011
In China, the distribution of the health workforce had changed a lot through medical system reform
The overall inequalities in the distribution of health workers decreased to the bottom at 2000, increased gently until 2011

Summary

Introduction

The aim of this study was to identify whether policies in different stages of medical system reform had been effective in decreasing inequalities and increasing the density of health workers in rural areas in China between 1985 and 2011. The quantity and distribution of the health workforce, the most important aspect of health care systems, directly influenced the quality and quantity of health services and the long-term development of the medical system [1,2]. In China, the distribution of the health workforce had changed a lot through medical system reform. The. Chinese government admitted that the previous medical system reform was a “failure” in 2005. Chinese government admitted that the previous medical system reform was a “failure” in 2005 It led to health inequality and poor accessibility of health services [5]. What happened to the Chinese health workforce in the periods of medical system reform?

Objectives

Results

Conclusion