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Incorporating Spatial Statistics into Examining Equity in Health Workforce Distribution: An Empirical Analysis in the Chinese Context

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  • Bin Zhu

    (School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
    Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China)

  • Chih-Wei Hsieh

    (Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China)

  • Yue Zhang

    (Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China)

Abstract

Existing measures of health equity bear limitations due to the shortcomings of traditional economic methods (i.e., the spatial location information is overlooked). To fill the void, this study investigates the equity in health workforce distribution in China by incorporating spatial statistics (spatial autocorrelation analysis) and traditional economic methods (Theil index). The results reveal that the total health workforce in China experienced rapid growth from 2004 to 2014. Meanwhile, the Theil indexes for China and its three regions (Western, Central and Eastern China) decreased continually during this period. The spatial autocorrelation analysis shows that the overall agglomeration level (measured by Global Moran’s I) of doctors and nurses dropped rapidly before and after the New Medical Reform, with the value for nurses turning negative. Additionally, the spatial clustering analysis (measured by Local Moran’s I) shows that the low–low cluster areas of doctors and nurses gradually reduced, with the former disappearing from north to south and the latter from east to west. On the basis of these analyses, this study suggests that strategies to promote an equitable distribution of the health workforce should focus on certain geographical areas (low–low and low–high cluster areas).

Suggested Citation

  • Bin Zhu & Chih-Wei Hsieh & Yue Zhang, 2018. "Incorporating Spatial Statistics into Examining Equity in Health Workforce Distribution: An Empirical Analysis in the Chinese Context," IJERPH, MDPI, vol. 15(7), pages 1-15, June.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:7:p:1309-:d:153888
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    References listed on IDEAS

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    1. Kreng, Victor B. & Yang, Chi-Tien, 2011. "The equality of resource allocation in health care under the National Health Insurance System in Taiwan," Health Policy, Elsevier, vol. 100(2), pages 203-210.
    2. Yi Tao & Kizito Henry & Qinpei Zou & Xiaoni Zhong, 2014. "Methods for measuring horizontal equity in health resource allocation: a comparative study," Health Economics Review, Springer, vol. 4(1), pages 1-10, December.
    3. Peige Song & Zhenghong Ren & Xinlei Chang & Xuebei Liu & Lin An, 2016. "Inequality of Paediatric Workforce Distribution in China," IJERPH, MDPI, vol. 13(7), pages 1-13, July.
    4. Kreng, Victor B. & Yang, Chi-Tien, 2011. "The equality of resource allocation in health care under the National Health Insurance System in Taiwan," Health Policy, Elsevier, vol. 100(2-3), pages 203-210, May.
    5. Bin Zhu & Yang Fu & Jinlin Liu & Ying Mao, 2018. "Modeling the Dynamics and Spillovers of the Health Labor Market: Evidence from China’s Provincial Panel Data," Sustainability, MDPI, vol. 10(2), pages 1-20, January.
    6. Michal Bernard Pietrzak, 2014. "The Modifiable Areal Unit Problem – Analysis Of Correlation And Regression," Equilibrium. Quarterly Journal of Economics and Economic Policy, Institute of Economic Research, vol. 9(4), pages 113-131, December.
    7. Trevor A. Sheldon & Peter C. Smith, 2000. "Equity in the allocation of health care resources," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 571-574, October.
    8. Waters, Hugh R., 2000. "Measuring equity in access to health care," Social Science & Medicine, Elsevier, vol. 51(4), pages 599-612, August.
    9. Bin Zhu & Jinlin Liu & Yang Fu & Bo Zhang & Ying Mao, 2018. "Spatio-Temporal Epidemiology of Viral Hepatitis in China (2003–2015): Implications for Prevention and Control Policies," IJERPH, MDPI, vol. 15(4), pages 1-17, April.
    10. Bin Zhu & Yang Fu & Jinlin Liu & Ying Mao, 2017. "Notifiable Sexually Transmitted Infections in China: Epidemiologic Trends and Spatial Changing Patterns," Sustainability, MDPI, vol. 9(10), pages 1-16, October.
    11. Rui Chen & Yali Zhao & Juan Du & Tao Wu & Yafang Huang & Aimin Guo, 2014. "Health Workforce Equity in Urban Community Health Service of China," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-15, December.
    12. Xinyu Zhang & Lin Zhao & Zhuang Cui & Yaogang Wang, 2015. "Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-15, December.
    13. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
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    1. White-Means, Shelley & Gaskin, Darrell J. & Osmani, Ahmad Reshad, 2019. "Intervention and Public Policy Pathways to Achieve Health Care Equity," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 16(14), pages 1-11.

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