IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i5p1520-d325771.html
   My bibliography  Save this article

Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017

Author

Listed:
  • Xiaolin Cao

    (School of Public Health, Fudan University, Shanghai 200032, China)

  • Ge Bai

    (School of Public Health, Fudan University, Shanghai 200032, China)

  • Chunxiang Cao

    (Faculty of Foreign Language, Weifang Medical University, Weifang 261042, Shandong, China)

  • Yinan Zhou

    (School of Public Health, Fudan University, Shanghai 200032, China)

  • Xuechen Xiong

    (School of Public Health, Fudan University, Shanghai 200032, China)

  • Jiaoling Huang

    (School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China)

  • Li Luo

    (School of Public Health, Fudan University, Shanghai 200032, China)

Abstract

Background: Although China began implementing medical reforms in 2009 aimed at fair allocation of the regional distribution of doctors, little is known of their impact. This study analyzed the geographic distribution of doctors from 2002 to 2017. Methods: This study calculated the Gini coefficient and Theil index among doctors in the eastern, central, and western regions (Category 1) of China, and in urban and rural areas (Category 2). The statistical significance of fairness changes was analyzed using the Mann–Whitney U test. Results: The annual growth rates of the number of doctors for the periods from 2002 to 2009 and 2010 to 2017 were 2.38% and 4.44%. The Gini coefficients among Category 1 were lower than those in Category 2, and statistically decreased after the medical reforms (P < 0.01) but continued to increase in Category 2 (P = 0.463). In 2017, the Theil decomposition result of Category 1 was 74.33% for the between-group, and in Category 2, it was 95.22% for the within-group. Conclusions: The fairness among the regional distribution of doctors in Category 1 is now at a high level and is better than that before the reforms. While the fairness in Category 2 is worse than that before the reforms, it causes moderate inequality and is continually decreasing. Overall unfairness was found to be derived from the between-group.

Suggested Citation

  • Xiaolin Cao & Ge Bai & Chunxiang Cao & Yinan Zhou & Xuechen Xiong & Jiaoling Huang & Li Luo, 2020. "Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017," IJERPH, MDPI, vol. 17(5), pages 1-13, February.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1520-:d:325771
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/5/1520/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/5/1520/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Fang, Pengqian & Dong, Siping & Xiao, Jingjing & Liu, Chaojie & Feng, Xianwei & Wang, Yiping, 2010. "Regional inequality in health and its determinants: Evidence from China," Health Policy, Elsevier, vol. 94(1), pages 14-25, January.
    2. 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.
    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. Isabel Correia & Paula Veiga, 2010. "Geographic distribution of physicians in Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 383-393, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. He, Wen, 2023. "Social medical insurance integration and health care disparities in China: Evidence from an administrative claim dataset," Economic Analysis and Policy, Elsevier, vol. 79(C), pages 20-39.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Ehsan Javanmardi & Sifeng Liu, 2019. "Exploring Grey Systems Theory-Based Methods and Applications in Analyzing Socio-Economic Systems," Sustainability, MDPI, vol. 11(15), pages 1-19, August.
    3. Rocha, António & Costa, Ana Sara & Figueira, José Rui & Ferreira, Diogo Cunha & Marques, Rui Cunha, 2021. "Quality assessment of the Portuguese public hospitals: A multiple criteria approach," Omega, Elsevier, vol. 105(C).
    4. 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.
    5. Jui-Kun Chiang & Yee-Hsin Kao & Ning-Sheng Lai, 2015. "The Impact of Hospice Care on Survival and Healthcare Costs for Patients with Lung Cancer: A National Longitudinal Population-Based Study in Taiwan," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-19, September.
    6. George Halkos & Georgia Argyropoulou, 2021. "Pollution and Health Effects: A Nonparametric Approach," Computational Economics, Springer;Society for Computational Economics, vol. 58(3), pages 691-714, October.
    7. Lane, Haylee & Sarkies, Mitchell & Martin, Jennifer & Haines, Terry, 2017. "Equity in healthcare resource allocation decision making: A systematic review," Social Science & Medicine, Elsevier, vol. 175(C), pages 11-27.
    8. Chin-Piao Yeh & Ai-Chi Hsu & Wei-Hsien & Kuang-Cheng Chai, 2014. "Neural Network Forecasts of Taiwan Bureau of National Health Insurance Expenditires," The International Journal of Business and Finance Research, The Institute for Business and Finance Research, vol. 8(5), pages 95-114.
    9. Jin-Li Hu & Min-Yueh Chuang & Shang-Ho Yeh, 2023. "A Dynamic DEA Analysis of Health Output Efficiencies of Cities and Counties in Taiwan," IJERPH, MDPI, vol. 20(6), pages 1-12, March.
    10. Masayoshi Hayashi, 2011. "The effects of medical factors on transfer deficits in Public Assistance in Japan: a quantile regression analysis," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 287-307, December.
    11. Zhongliang Zhou & Yu Fang & Zhiying Zhou & Dan Li & Dan Wang & Yanli Li & Li Lu & Jianmin Gao & Gang Chen, 2017. "Assessing Income-Related Health Inequality and Horizontal Inequity in China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 132(1), pages 241-256, May.
    12. Stéphanie Truchet & Nicolas Mauhe & Marie Herve, 2017. "Veterinarian shortage areas: what determines the location of new graduates?," Review of Agricultural, Food and Environmental Studies, Springer, vol. 98(4), pages 255-282, December.
    13. Xiao Tan, 2017. "Explaining provincial government health expenditures in China: evidence from panel data 2007–2013," China Finance and Economic Review, Springer, vol. 5(1), pages 1-21, December.
    14. Mougeot, Michel & Naegelen, Florence, 2018. "Achieving a fair geographical distribution of health-care resources," Regional Science and Urban Economics, Elsevier, vol. 70(C), pages 384-392.
    15. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2022. "Can greater access to secondary health care decrease health inequality? Evidence from bus line introduction to Arab towns in Israel," Economic Modelling, Elsevier, vol. 106(C).
    16. Hao, Yu & Liu, Jiahui & Lu, Zhi-Nan & Shi, Ruijie & Wu, Haitao, 2021. "Impact of income inequality and fiscal decentralization on public health: Evidence from China," Economic Modelling, Elsevier, vol. 94(C), pages 934-944.
    17. Xiangyu Sun & Eduardo Bernabé & Xuenan Liu & Jennifer Elizabeth Gallagher & Shuguo Zheng, 2016. "Determinants of Catastrophic Dental Health Expenditure in China," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-12, December.
    18. Aizawa, Toshiaki, 2019. "Ex-ante Inequality of Opportunity in Child Malnutrition: New Evidence from Ten Developing Countries in Asia," Economics & Human Biology, Elsevier, vol. 35(C), pages 144-161.
    19. Martin Lábaj & Peter Silanič & Christoph Weiss & Biliana Yontcheva, 2018. "Market structure and competition in the healthcare industry," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(8), pages 1087-1110, November.
    20. Fafa Yan & Alec Zuo & Wen’e Qi & Zhimin Zhou, 2023. "The Effect of Ecological Management on Regional Health Inequality," IJERPH, MDPI, vol. 20(4), pages 1-22, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1520-:d:325771. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.