Abstract

BackgroundThe licensed doctor misdistribution is one of the major challenges faced by China. However, this subject remains underexplored as spatial distribution characteristics (such as spatial clustering patterns) have not been fully mapped out by existing studies. To fill the void, this study aims to explore the spatio-temporal dynamics and spatial clustering patterns of different subtypes of licensed doctors (i.e., clinicians, traditional Chinese medicine doctors, dentists, public health doctors, general practitioners) in China.MethodsData on the licensed doctor quantity and population during 2012–2016 was obtained from the National Health (and Family Planning) Yearbook. Functional boxplots were used to visualize and compare the temporal trends of densities of different subtypes of licensed doctors. This study adopted two complementary spatial statistics (space-time scan statistics and Moran’s I statistics) to explore the spatio-temporal dynamics and spatial clustering patterns of licensed doctor distribution in China. The former was used to explore the spatial variations in the temporal trends of licensed doctor density during 2012–2016, and the latter was adopted to explore the spatial changing patterns of licensed doctor distribution during the research period.ResultsThe results show that the densities of almost all subtypes of licensed doctors displayed upward trends during 2012–2016, though some provincial units were left behind. Besides, spatial distribution characteristics varied across different subtypes of licensed doctors, with the low-low cluster area of general practitioners being the largest.ConclusionsThe misdistribution of licensed doctors is a global problem and China is no exception. In order to achieve a balanced distribution of licensed doctors, the government is suggested to introduce a series of measures, such as deliberative policy design and effective human resource management initiatives to educate, recruit, and retain licensed doctors and prevent a brain drain of licensed doctors from disadvantaged units.

Highlights

  • The licensed doctor misdistribution is one of the major challenges faced by China

  • As for its four components, clinicians accounted for the largest proportion of licensed doctors in all the provincial units, while the density of public health doctors was usually smaller when compared to dentists and Traditional Chinese medicine (TCM) doctors in a provincial unit

  • Beijing owned the highest density of all subtypes of licensed doctors, while the lowest average densities of clinicians, TCM doctors, dentists, and public health doctors were located in Xizang, Anhui, Xizang, Hebei, respectively

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Summary

Introduction

The licensed doctor misdistribution is one of the major challenges faced by China. This subject remains underexplored as spatial distribution characteristics (such as spatial clustering patterns) have not been fully mapped out by existing studies. In an analysis of the global workforce, Chen and colleagues [4] reported that the increased density of healthcare workers in a population is associated with the improvement of population-based health and human survival. World Health Organization (WHO) [6] has used the density of skilled health professionals per 1000 population as an important indicator to assess the performance of a healthcare system

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