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Examining the Multi-Scalar Unevenness of High-Quality Healthcare Resources Distribution in China

Author

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  • Meng Yu

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

  • Shenjing He

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

  • Dunxu Wu

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

  • Hengpeng Zhu

    (Public Policy Research Center, Chinese Academy of Social Sciences, Beijing 100732, China)

  • Chris Webster

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

Abstract

Healthcare disparity is, to a large extent, ascribable to the uneven distribution of high-quality healthcare resources, which remains insufficiently examined, largely due to data unavailability. To overcome this barrier, we synthesized multiple sources of data, employed integrated methods and made a comprehensive analysis of government administrative structures and the socio-economic environment to build probably the most inclusive dataset of Chinese 3-A hospitals thus far. Calibrated on a sample of 379 hospitals rated by a reputable organization, we developed a realistic and viable evaluation framework for assessing hospital quality in China. We then calculated performance scores for 1246 3-A hospitals, which were aggregated and further analyzed at multiple scales (cities, provinces, regions, and economic zones) using general entropy indexes. This research shows that the fragmented governance and incoordination of “ kuai ” and “ tiao ” is rooted deeply in China’s legacy of centrally-planned systems, and has had a far-reaching yet partially contradictory influence over the contemporary distribution and performance of healthcare resources. Additionally, the unevenness in the distribution of healthcare resources is related closely to a city’s administrative rank and power. This study thus suggests that the policy design of healthcare systems should be coordinated with external socio-economic transformation in a sustainable manner.

Suggested Citation

  • Meng Yu & Shenjing He & Dunxu Wu & Hengpeng Zhu & Chris Webster, 2019. "Examining the Multi-Scalar Unevenness of High-Quality Healthcare Resources Distribution in China," IJERPH, MDPI, vol. 16(16), pages 1-20, August.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2813-:d:255445
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    References listed on IDEAS

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    1. Zhang, Xiaobo & Kanbur, Ravi, 2005. "Spatial inequality in education and health care in China," China Economic Review, Elsevier, vol. 16(2), pages 189-204.
    2. Cowell, Frank A. & Kuga, Kiyoshi, 1981. "Additivity and the entropy concept: An axiomatic approach to inequality measurement," Journal of Economic Theory, Elsevier, vol. 25(1), pages 131-143, August.
    3. Kanbur, Ravi, 2000. "Income distribution and development," Handbook of Income Distribution, in: A.B. Atkinson & F. Bourguignon (ed.), Handbook of Income Distribution, edition 1, volume 1, chapter 13, pages 791-841, Elsevier.
    4. Stephen P. Jenkins, 2006. "Estimation and interpretation of measures of inequality, poverty, and social welfare using Stata," North American Stata Users' Group Meetings 2006 16, Stata Users Group, revised 06 Dec 2008.
    5. Martin Biewen & Stephen P. Jenkins, 2006. "Variance Estimation for Generalized Entropy and Atkinson Inequality Indices: the Complex Survey Data Case," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 68(3), pages 371-383, June.
    6. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    7. Pauline W Jansen & Fiona K Mensah & Jan M Nicholson & Melissa Wake, 2013. "Family and Neighbourhood Socioeconomic Inequalities in Childhood Trajectories of BMI and Overweight: Longitudinal Study of Australian Children," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
    8. Eriksson, Tor & Pan, Jay & Qin, Xuezheng, 2014. "The intergenerational inequality of health in China," China Economic Review, Elsevier, vol. 31(C), pages 392-409.
    9. Jonathan Haughton & Shahidur R. Khandker, 2009. "Handbook on Poverty and Inequality," World Bank Publications - Books, The World Bank Group, number 11985.
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