Equity In Allocation Research Articles

Equity and trends in the allocation of health human resources in China from 2012 to 2021

BackgroundAs the second most populous country in the world, China has a huge demand for health human resources. Over the past decade, the Chinese government has continuously increased investment in the health sector and implemented relevant policies and systems in an attempt to enhance the overall quantity and equity of health human resources. This study aims to analyze the equity and developmental trends in the allocation of health human resources in China from 2012 to 2021, providing reference and theoretical support for the government’s further optimization of health human resources allocation.MethodsThis study collected health human resources data from 31 provinces, municipalities, and autonomous regions in China from 2012 to 2021. The methods employed included Lorenz curves, Gini coefficients, and agglomeration degree analysis, which examined the developmental trends and equity of health human resources from the perspectives of population and geographical.ResultsThis study found that over the past decade, there has been a significant increase in the total quantity of health human resources in China, accompanied by an improvement in equity, although disparities still exist. There are notable variations in the distribution of health human resources based on geographical area, with disparities between different regions. Relative shortages of health human resources are observed in western regions, while some areas in the eastern and central regions exhibit an abundance or surplus of health human resources.ConclusionOverall, health human resources in China have experienced stable development, with an incremental improvement in allocation equity, yet there remains considerable room for progress. It is imperative to continue strengthening policy guidance and regulation to facilitate the rational flow of health human resources, narrow regional disparities, and achieve the goal of universal health coverage.

Equity and efficiency of health resource allocation in the Chengdu-Chongqing Economic Circle of China.

This study aimed to evaluate the fairness and efficiency of health resource allocation (HRAE) in Chengdu-Chongqing Economic Circle after the new healthcare reform. This study also aimed to identify existing problems, providing empirical evidence for the government to formulate regional health plans scientifically and reasonably. The fairness of health resource allocation was analyzed using the Gini coefficient, Theil index, and agglomeration degree from population and geographical area perspectives. The three-stage data envelopment analysis and the Malmquist productivity index were used to analyze HRAE from static and dynamic perspectives. The Gini coefficient for population allocation in Chengdu-Chongqing Economic Circle was 0.066-0.283, and the Gini coefficient for geographical area allocation was 0.297-0.469. The contribution rate within a region was greater than that between regions, and health resources were mainly concentrated in economically developed core areas. The overall fairness of Chengdu Economic Circle was relatively better than that of Chongqing Economic Circle. Moreover, the adjusted mean technical efficiency was 0.806, indicating room for HRAE improvement in Chengdu-Chongqing Economic Circle. Stochastic Frontier Analysis found that different environmental variables have varying degrees of impact on HRAE. The adjusted mean total factor productivity change (Tfpch) was 1.027, indicating an overall upward trend in HRAE since the new healthcare reform. However, scale efficiency change (Sech) (0.997) limited the improvement of Tfpch. The fairness of health resources allocated by population was better than that allocated by geographical area. The unfairness of health resources mainly stemmed from intra-regional differences, with considerable health resources concentrated in core areas. Over the past 13 years, HRAE has improved but exhibited spatial heterogeneity and Sech-hindered productivity improvement. The study recommends strengthening regional cooperation and sharing to promote the integrated and high-quality development of the health and well-being in Chengdu-Chongqing Economic Circle.

Federal Public Resources in Response to Natural Disasters in Rio Grande do Sul

Objective: The objective of this study is to analyze the sources and allocation of federal public resources applied to natural disasters in the Brazilian state of Rio Grande do Sul in 2024. Theoretical Framework: Based on Public Choice Theory, the study investigates how self-interests can influence the allocation of public resources, which is relevant in the context of Brazilian public administration. Method: Using a descriptive and documentary approach, this qualitative research collected data from provisional measures and the Transparency Portal, analyzing the sources and amounts of funds quantitatively and their allocations qualitatively through the lens of Public Choice Theory. Results and Discussion: Most of the funds come from Official Credit Operations (41.80%) and Federal Financial Charges (13.97%). The allocation covers a range of areas from climate change mitigation to support for microenterprises. The diversity of allocations suggests an effort to meet multiple emerging needs and maximize political benefits, reflecting the influence of self-interests in public management. Research Implications: The study emphasizes the importance of transparency and accountability in public management, especially in disaster situations. By revealing how resources are allocated and identifying potential influences of self-interests, the research contributes to the formulation of more efficient and equitable public policies. Detailed understanding of the allocations can improve accountability and integrity in resource allocation, promoting governance practices that increase public trust in government actions. Originality/Value: Applying Public Choice Theory, this study offers insights into the efficiency and equity of resource allocation for natural disasters in Rio Grande do Sul, contributing to the literature on disaster management and public administration in Brazil.

Filling the blindspots: Assessing distributive equity in fund allocation of Florida's local housing program for disaster recovery

Despite the role of local assistance in addressing households' disaster recovery needs, few studies have examined the role of localized programs in filling the gaps that might exist in federal programs. To address the question of whether local recovery funds distribute resources to socially vulnerable neighborhoods and how local assistance fits into the broader federal disaster assistance landscape, we take Florida's State Housing Initiatives Partnership (SHIP) program as a case study. The SHIP program can help fill neighborhood-level gaps left by the Federal Emergency Management Agency's (FEMA) Individual Assistance program by aiding neighborhoods with the higher proportions of 1) those who did not receive federal assistance or 2) those who had residual damages not fully covered by federal assistance. The study finds that SHIP funds typically flow into socially vulnerable neighborhoods with a higher proportion of Black and Hispanic residents, even without specific social or racial equity measures built into program regulations. The study highlights the importance of balancing the consistency of fundamental rules and having flexibility in distributing funds.

Going the distance: Geographic effects of the lung transplant composite allocation score

BackgroundIn March 2023, the lung allocation policy underwent major changes from a tiered structure to a composite allocation score (CAS). The goal was to improve allocation equity for disadvantaged groups by deprioritizing transplant distance. This study examines the effects of CAS on geographic trends and transportation efficiency. MethodsA retrospective cohort study was conducted using the United Network for Organ Sharing (UNOS) database, queried for adult lung transplants from 9/1/2022 - 9/1/2023. Outcomes were nautical distance of transplant, ischemic time, and flight required for transport (estimated as distance >100 miles). Perioperative complications and early survival were analyzed, with propensity-matching to account for baseline differences. ResultsA total of 1394 pre-CAS and 1197 post-CAS patients were included in the study cohort. Post-CAS recipients were less likely to be ABO type O (39.2% vs 47.3%, p<0.001), and were less likely to be an identical ABO match (82.7% vs. 91.0%, p < 0.001). The CAS cohort travelled significantly further (354.0 mi. [IQR:139 – 657] vs. 195.0 mi. [IQR:78 – 388], p < 0.001). CAS patients had longer ischemic times (6.8 hrs. [IQR: 5.3 – 8.9] vs. 6.0 hrs. [IQR:4.8 – 7.5], p < 0.001), and CAS procurements were more likely to require a flight for transport (n = 934, 78.0% vs. n = 991, 71.1%, p<0.001). However, waitlist time was shorter (28 days [IQR = 9 – 83] vs. 33 days [IQR = 11 – 109]) as was length of stay (24.21 ± 17.84 days vs. 31.44 ± 30.19 days, p<0.001) for CAS recipients, which remained true after propensity-matching. ConclusionThe lung CAS policy change was intended to eliminate geographic boundaries for disadvantaged patients but has expanded transplant distances, with an expected increase in ischemic time and need for flights which affect transplant economics. Although efforts were made to improve transplant availability for the disadvantaged ABO type O group, early assessment of the recipient cohort showed that recipients with blood group type O were actually less likely to be transplanted under the new policy. Positive effects include an overall decrease in waitlist time, but further investigation is warranted to evaluate the effectiveness, equity, and economic sustainability of the new policy.

Evaluating temporal variations in access to multi-tier hospitals using personal vehicles and public transit: Implications for healthcare equity

Understanding healthcare accessibility, or the ability to access healthcare services, has significant implications for both individual well-being and community equity. However, existing studies seldom account for temporally varying factors such as traffic conditions and hospital schedules, resulting in miscalculation of accessibility. This study addresses this gap by introducing a framework that evaluates accessibility to multi-tier hospitals, factoring in both spatial and temporal aspects, using public transit (PT) and personal vehicles (PVs), and assesses its impact on horizontal and vertical equity. Implemented in Shanghai, China, we employ the Gaussian two-step floating catchment area method for accessibility quantification and utilize map APIs for dynamic travel time data. Our analysis reveals: (i) notable temporal fluctuations in healthcare accessibility, especially for PT, and their significant impact on both horizontal and vertical equity due to varying travel times and hospital schedules; (ii) larger disparities in higher-tier hospital accessibility compared to lower-tier ones; (iii) greater horizontal equity using PV-based accessibility and higher vertical equity using PT-based accessibility. These findings highlight the need to offer customized transit to healthcare facilities, expand telehealth services, incorporate equity in healthcare resource allocation, incentivize healthcare professionals to work in underserved areas, and develop outreach programs to improve accessibility and equity.

Analysis of regional water resources spatial pattern and allocation equity

Water scarcity is a worldwide concern, and with the impact of climate change and human activities, the imbalance in the distribution of water resources has further intensified. The equitable allocation of water resources has become a thorny issue for water resources management authorities. It is challenging to find a relatively equitable method of water resources allocation. This study aims to propose a method for evaluating the fairness of water resources allocation, which can be used both to evaluate the fairness of water resources allocation and as a basis for water resources allocation decisions. The specific approach is to first analyze the spatial pattern of regional water resources by using water resources abundance and water resources intensity, and then to conduct a comprehensive analysis of regional water resources allocation fairness by combining Lorenz curve, Gini coefficient and Theil index to form an index system that can systematically analyze the spatial pattern of water resources, allocation fairness and its changes. A real-world example study was conducted in the Yangtze River Delta region of China, and the results showed that the index system can well reflect the allocation of water resources among regions and cities within the region. The results obtained using this method can provide some reference for promoting coordinated regional development.

Equity in Kidney Allocation and Optimizing Utilization: Are These Goals Mutually Exclusive?

Equity in Kidney Allocation and Optimizing Utilization: Are These Goals Mutually Exclusive?

Evaluating the Correlation Between Anteroposterior Diameter, Body Surface Area, and Height for Liver Transplant Donors and Recipients.

Small stature and female sex correlate to decreased deceased donor liver transplant (DDLT) access and higher waitlist mortality. However, efforts are being made to improve access and equity of allocation under the new continuous distribution (CD) system. Liver anteroposterior diameter (APD) is a method used by many centers to determine size compatibility for DDLT but is not recorded systematically, so it cannot be used for allocation algorithms. We therefore seek to correlate body surface area (BSA) and height to APD in donors and recipients and compare waitlist outcomes by these factors to support their use in the CD system. APD was measured from single-center DDLT recipients and donors with cross-sectional imaging. Linear, Pearson, and PhiK correlation coefficient were used to correlate BSA and height to APD. Competing risk analysis of waitlist outcomes was performed using United Network for Organ Sharing data. For 143 pairs, donor BSA correlated better with APD than height (PhiK = 0.63 versus 0.20). For recipient all comers, neither BSA nor height were good correlates of APD, except in recipients without ascites, where BSA correlated well (PhiK = 0.63) but height did not. However, among female recipients, BSA, but not height, strongly correlated to APD regardless of ascites status (PhiK = 0.80 without, PhiK = 0.70 with). Among male recipients, BSA correlated to APD only in those without ascites (PhiK = 0.74). In multivariable models, both BSA and height were predictive of waitlist outcomes, with higher values being associated with increased access, decreased delisting for death/clinical deterioration, and decreased living donor transplant (model concordance 0.748 and 0.747, respectively). Taken together, BSA is a good surrogate for APD and can therefore be used in allocation decision making in the upcoming CD era to offset size and gender-based disparities among certain candidate populations.

Multi-criteria comparison analysis of spatial equity for emergency shelters in old and new urban districts: A case study in Wuhua District and Chenggong District of Kunming City, China

With the progression of urbanization and the concentration of populations in urban areas, cities are increasingly exposed to disaster risks. Emergency shelters play a critical role in disaster prevention and mitigation, as they are vital for providing temporary refuge and protection during and after catastrophic events. Assessing the spatial equity of these shelters is conducive to enhancing emergency relief capabilities and aiding in disaster risk reduction. However, there remains a lack of clarity regarding the comparative and quantitative disparities between new and old urban areas, particularly in developing countries like China, where urbanization is rapid and populations are dense. To address this issue, this study employed a combination of multi-source data and GIScience technology to analyze the spatial equity of emergency shelters in Wuhua District and Chenggong District of Kunming City, China. We evaluated the overall spatial equity of emergency shelters in both the old urban area (Wuhua District) and the new urban area (Chenggong District) using a comprehensive evaluation model with three criteria: evacuation population capacity, spatial accessibility, and the level of per capita effective shelter area. The results revealed that the old urban area suffers from insufficient effective emergency shelter capacity due to saturated construction land. More than 67 % of the shelters are short-term emergency shelters located close to buildings, which compromises spatial accessibility during earthquake disasters. The level of per capita effective shelter area, as indicated by SSTD, is 24.42 in Wuhua District, suggesting that the effective shelter area in each subdistrict is consistently low, regardless of its urban or suburban classification. In contrast, the new urban district boasts substantial effective emergency shelter capacities, both in the long-term and short-term types, surpassing the reference capacities. The rational spatial layout of various types of emergency shelters ensures that most regions with concentrated buildings are enveloped in accessibility time layers within a 25-min range. The SSTD index of Chenggong District is 349.23, underscoring the significant disparity in the level of per capita effective shelter area at the subdistrict scale, particularly in the district's urban villages and suburban regions. The findings of this study serve as a scientific reference for emergency management and urban planners to reasonably plan or upgrade shelter facilities, thereby improving urban resilience and promoting spatial equity in resource allocation among subdistricts, communities, and residents.

A Triple Bottom Line optimization model for assignment and routing of on-demand home services

‘On-demand home services’ is a fast-growing industry where online platforms match independent service professionals with customers seeking aid for household tasks. In this paper, we study the assignment and routing of service professionals for serving customers of an on-demand home services platform considering the Triple Bottom Line (TBL) criteria for ensuring sustainability in operations. We characterize this as the Home Services Assignment and Routing Problem with the Triple Bottom Line (HSARP-TBL) and implement a Mixed Integer Linear Programming (MILP) model for solving it. We assign service professionals to customers based on their desired time slots and also transport modes for each customer visit by a professional, considering either combinations of public transport or a personal vehicle for each professional’s tour. The objective is to minimize costs due to time window violations and uncovered customers, catering to the economic pillar of the TBL. We incorporate additional constraints related to the TBL by improving customer satisfaction based on the ratings of assigned professionals to customers, with and without subscription (economic), controlling emissions due to transportation of professionals (environmental) and ensuring equity in service allocation and net earnings between professionals (social). For tackling large instances we implement a Hybrid Genetic Search (HGS) algorithm adapting it to our problem setting. We demonstrate that the HGS outperforms the MILP model systematically for large instances in terms of solution value and computational time. Finally, we observe that for some instances, without worsening the primary economic objective, all the TBL indicators can be improved.

A Novel Auction-Based Truck Appointment System for Marine Terminals

Background: Increased maritime trade has led to a surge in drayage operations, causing congestion and environmental issues in port areas. Truck Appointment Systems (TASs) are commonly used to manage truck arrival rates, yet transparency and equity in slot allocation remain problematic, fostering distrust between Licensed Motor Carriers (LMCs) and Marine Terminal Operators (MTOs). Methods: This study proposes a polycentric approach to improve truck scheduling and ensure that those impacted by decisions are involved in the decision-making process. A single-round auction mechanism focused on optimizing the truck hauling process through a pricing policy that promotes sincere bidding is introduced. The proposed approach employs an optimization strategy to achieve equitable coordination in truck synchronization through means of adaptable capacity management. Results: Numerical experiments assessing scenarios of noncollaborative behavior against partial collaboration between MTOs and LMCs demonstrate the effectiveness of the proposed approach in enhancing user satisfaction and terminal conditions for a case study focused on a medium-sized terminal. Collaboration between trucking companies is shown to increase utility per monetary unit spent on slot acquisition. Conclusions: The polycentric strategy offers a solution to TAS limitations by ensuring stakeholder participation with respect to flexibility and transparency by ensuring that those impacted by decisions are involved in the decision-making process.

Impact of the Kidney Allocation Revision on Access to Kidney Transplantation and Outcomes in the United States.

The 2014 Kidney Allocation System (KAS) revision aimed to enhance equity in organ allocation and improve patient outcomes. This study assesses the impacts of the KAS revision on renal transplantation demographics and outcomes in the United States. We conducted a retrospective study utilizing the Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients (OPTN/SRTR) database from 1998 to 2022. We compared recipient and donor characteristics, and outcomes (graft failure and recipient survival) pre- and post-KAS revision. Post-KAS, recipients were significantly older (53 vs 48, P < .001) with an increase in Medicaid beneficiaries (7.3% vs 5.5%, P < .001). Despite increased graft survival, HR = .91 (95% CI 0.80-.92, P < .001), overall recipient survival decreased, HR = 1.06 (95% CI 1.04-1.09, P < .001). KAS revision led to greater racial diversity among recipients and donors, enhancing equity in organ allocation. However, disparities persist in graft failure rates and recipient survival across racial groups. The 2014 Kidney Allocation System revision has led to important changes in the renal transplantation landscape. While progress has been made towards increasing racial equity in organ allocation, further refinements are needed to address ongoing disparities. Recognizing the changing patient profiles and socio-economic factors will be crucial in shaping future policy modifications.

Equity and efficiency of health resource allocation in township health centers in Sichuan Province, China.

To analyze the equity and efficiency of health resource allocation in township health centers in Sichuan Province, and to provide a scientific basis for promoting the development of township health centers in Sichuan Province, China. The Lorenz curve, Gini coefficient and health resource density index were used to analyze the equity of health resource allocation in township health centers in Sichuan Province from 2017 to 2021, and data envelopment analysis(DEA) was used to analyze the efficiency of health resource allocation in township health centers in Sichuan Province from 2017 to 2021. The Gini coefficient of health resources of township health centers in Sichuan Province is below 0.2 by population in addition to the number of beds in 2020-2021 and practicing (assistant) physicians in 2021, and the Gini coefficient of health resources of township health centers in Sichuan Province is above 0.6 by geography. The Lorentz curve of health resources of township health centers in Sichuan Province is closer to the equity line by population allocation and further from the equity line by geographical allocation. The average level of township health centers in Sichuan Province is used as the standard to calculate the health resource density standard index(W) of each region, the Ws of Panzhihua, Ganzi, Aba and Liangshan are less than 1, and the Ws of Ziyang, Neijiang, Deyang and Meishan are greater than 1. The overall efficiency of township health centers in Sichuan Province in 2017 and 2021 is 1, and the DEA is relatively effective. The overall efficiency of township health centers in Sichuan Province in 2018 and 2019 is not 1, and the DEA is relatively ineffective. The overall efficiency of all health resources in Mianyang and Ziyang is 1, and the DEA is relatively effective. The overall efficiency of all health resources in Suining, Neijiang, Yibin, Aba and Ganzi is not 1, and the DEA is relatively ineffective. The equity of health resource allocation by population is better than that by geography in township health centers in Sichuan Province. Combining population and geographical factors, the health resource allocation of Panzhihua, Ganzi, Aba and Liangshan is lower than the average level of Sichuan Province. The efficiency of health resource allocation in township health centers in Sichuan Province is low.

Study on the allocation efficiency of medical and health resources in Hainan Province: Based on the super-efficiency SBM-Malmquist model.

The equity and efficiency of medical and health resource allocation is the key point of health reform in all countries. Poor allocation efficiency of health resources will seriously affect the sustainable and high-quality development of health causes. Hainan Province is the only free trade port with Chinese characteristics in China, which means that Hainan has ushered in a brand-new development under the policy of free trade port. This study aims to adopt policies to improve the efficiency of medical and health resource allocation in Hainan Province and provide references for other regions. In this study, the Super-efficiency SBM and Malmquist models were used to analyze the static and dynamic efficiency of medical and health resource allocation in Hainan Province during 2016-2020. The results showed that, statically, the average efficiency of comprehensive allocation of health resources in Hainan Province from 2016 to 2020 was 0.975, showing poor overall performance and significant regional differences. Dynamically, the average index of allocation efficiency of medical and health resources was 0.934, showing a negative growth trend. The technical efficiency and scale efficiency of health resource allocation efficiency showed positive growth, while the technical progress and pure technical efficiency showed negative growth. It shows that it is influenced by both scale efficiency and technological progress, among which technological progress is the key factor. Therefore, some policy suggestions are put forward to further optimize the allocation of medical and health resources and improve utilization efficiency.

Bridging the gap: coordinating equity and efficiency in older people care resource allocation in China

BackgroundWith the increasing global aging population, how to allocate older people care resources reasonably has become an increasingly urgent international issue. China, as the largest developing country, has made many efforts to actively respond to the challenges of an aging population. However, there are still problems with uneven allocation of older people care resources and low efficiency of allocation. Therefore, this study evaluates the regional differences and dynamic evolution of the equity and efficiency of older people care resource allocation in China from 2009 to 2020, and explores ways to change the current situation.MethodsThe data used in this study were derived from the “China Statistical Yearbook” and the “China Civil Affairs Statistical Yearbook” for the period of 2010–2021. Firstly, the equity of older people care resource allocation was measured using the Gini coefficient, the Theil index, the Older People Care Resource Density Index, and the Older People Care Resource Agglomeration Degree. Secondly, the dynamic Slack-Based Measure data envelopment analysis method was adopted to evaluate efficiency. Lastly, the Z-score is used to normalize the equity index and perform classification matching with the efficiency value. Spatial autocorrelation analysis and hotspot analysis were conducted using GIS technology to examine the dynamic evolution process of older people care resource allocation equity and efficiency, as well as their spatial distribution patterns and coordination across provinces from 2009 to 2020.ResultsThe equity analysis showed that the spatial distribution of various types of older people care resources was uneven, and the differences were mainly due to internal differences within each region, with the largest equity differences observed in western provinces. Currently, older people care resources are mainly concentrated in eastern regions, while the total amount of older people care resources in western regions and some central regions is relatively small, which cannot meet the older people care needs of residents. The efficiency analysis results showed that the efficiency of older people care resource allocation has been improving over the past 12 years, and in 2020, 77.42% of provinces were located on the efficiency frontier with an average efficiency value of 0.9396. Finally, the coordination analysis results showed that there were significant spatiotemporal differences in the equity and efficiency of older people care resources allocation.ConclusionWith the development of society and economy, the total amount and service capacity of older people care resources in China have greatly improved. However, there are still significant spatiotemporal differences in the equity and efficiency of older people care resource allocation. The development of older people care services in central and eastern provinces is unbalanced, and there is a polarization trend in terms of equity and efficiency of older people care resource allocation. Most provinces in western regions face the dual dilemma of inadequate older people care resources and low utilization efficiency. It is recommended that policymakers comprehensively consider population and geographic factors in different provinces, establish relevant allocation standards according to local conditions, improve the redistribution system, and focus on increasing the total amount of older people care resources in underdeveloped provinces while promoting resource flow.

Distributive justice and equity in resource allocation: a temporal analysis of hospitalization costs in indigenous populations in Brazil

IntroductionIn Brazil, a country of continental dimensions, the health needs of each region have an impact. In this context and the name of the principle of equity, the SUS organizes actions especially aimed at social groups such as the elderly, children, pregnant women, and indigenous peoples. The concept of justice proposed by John Rawls is one of equity, which is essential to this country.MethodsThis is an ecological, descriptive study, which analyzed hospital spending on cardiovascular diseases in the Unified Health System (SUS) among the indigenous elderly population and other ethnicities/colors in Brazil, between 2010 and 2019.ResultsHospitalization costs and fatality rates for indigenous populations and other colors/ethnicities, between 2010 and 2019, were evaluated. A reduction in hospitalization costs for the indigenous population and an increase in other populations was observed throughout the historical series, while there was an increase in fatality rates for both groups. A comparison was made between hospitalization costs and the fatality rates of indigenous populations and other colors/ethnicities according to sex, between 2010 and 2019. It was observed that regardless of sex, there are significant differences (p<0.05) between hospitalization costs and fatality rates, with higher costs for patients of other colors/ethnicities and higher fatality rates for the indigenous population.ConclusionsHospitalization costs due to cardiovascular diseases in elderly people from indigenous populations were lower compared to other ethnicities in most federative units, which may suggest an unequal allocation of resources or access for this indigenous population to the SUS. Although there is no strong correlation between spending on hospital admissions and fatality rates, it was found that these rates increased between 2010 and 2019, while spending was reduced.

Trend and Equity in Maternal and Child Health Resource Allocation in China Since the New Health System Reform: A Nationwide Study from 2008 to 2020.

China has made considerable efforts to promote the development of maternal and child health (MCH) care since the new health system reform in 2009. This study aims to evaluate the trend and equity of MCH resources allocation in China from 2008 to 2020 and provide a reference for rational distribution of MCH resources. Data were collected from the China Health Statistics Yearbook and China Statistics Yearbook. The number of MCH hospitals, licensed (assistant) physicians, registered nurses and beds were selected for the measurement of the equity of MCH resources allocation. The Health Resource Agglomeration Degree and Theil index were used in evaluating MCH resource allocation equity and to compare differences among regions. From 2008 to 2020, the average annual growth rates for MCH hospitals, beds, licensed (assistant) physicians, and registered nurses were 0.72%, 6.95%, 5.04%, and 9.57%, respectively. However, regional disparities in the equity of MCH resource allocation have been identified. Although the western region has shown growth in MCH resource allocation by geography, the agglomeration degree of the four indicators remains less than 1, significantly lower than the average value of greater than 2 in the eastern region. Additionally, the equity of human resource allocation in the western region is lower than the equity in the allocation of institutions. In the densely populated eastern region, the equity of MCH resource allocation by population is decreasing, with the agglomeration degree of all four indicators below 1 in 2020. The disparity in healthcare resource allocation within regions is the main cause of inequitable MCH resource allocation in China. The allocation of MCH resources in China has improved since 2009, however, geographic equity needs further improvement, particularly in densely populated regions. Population and geographic balances should be considered in the development and implementation of MCH resource allocation policies, and improving intraregional equity should be the focus.

Equity of health resource allocation in Chongqing, China, in 2021: a cross-sectional study

BackgroundChongqing, the most populous city in Southwest China. This study aims to examine the equity of health resource allocation in Chongqing using the latest statistics, analyse possible shortcomings and propose...

Equity analysis of older adult resource allocation in China.

To evaluate the current status and equity of older adult resource allocation in the 31 provinces (autonomous regions and municipalities) of mainland China, and to offer recommendations for the optimization of these allocations. Four key indicators, namely, the number of older adult institutions, employees, professionals, and beds in mainland China in the year 2020, were used and analyzed using various methods and tools, including agglomeration analysis, the Gini coefficient, and the Lorenz Curve. These methods were applied to evaluate the equity of older adult resource allocation across the different provinces (autonomous regions and municipalities) and regions of China, using two dimensions, namely, the geographical area and the older adult population. Overall, the number of older adult resource allocations was found to be increasing in China, while the number of employees with educational levels of junior college or above was relatively low and the population structure was aging. In terms of the equity of older adult resource allocation, the results showed that this was good according to the dimensions of the older adult population but was on the low side based on the dimension of geographical area, and the Gini coefficient of the western region, in particular, was in an alarming state. Different provinces (autonomous regions and municipalities) were found to have an uneven allocation of resources for older adults, with large differences, with some areas having a serious under-allocation of resources, while others showed resource over-allocation. While China's allocation of older adult resources is relatively equitable, there is nevertheless a need to take into account recent changes in the older adult population and strengthen the construction of a reasonably structured, high-quality team of professionals and technicians, as well as consider factors such as geographical area and the older adult population, and rationally allocate older adult resources in the eastern, middle, and western regions, to achieve a balanced allocation in terms of equity and efficiency and enhance social capital, to better satisfy the demands for older adult services in older adults at multiple levels.