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

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 a...

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Autores principales: Cao, Xiaolin, Bai, Ge, Cao, Chunxiang, Zhou, Yinan, Xiong, Xuechen, Huang, Jiaoling, Luo, Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084928/
https://www.ncbi.nlm.nih.gov/pubmed/32120925
http://dx.doi.org/10.3390/ijerph17051520
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author Cao, Xiaolin
Bai, Ge
Cao, Chunxiang
Zhou, Yinan
Xiong, Xuechen
Huang, Jiaoling
Luo, Li
author_facet Cao, Xiaolin
Bai, Ge
Cao, Chunxiang
Zhou, Yinan
Xiong, Xuechen
Huang, Jiaoling
Luo, Li
author_sort Cao, Xiaolin
collection PubMed
description 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.
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spelling pubmed-70849282020-03-23 Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017 Cao, Xiaolin Bai, Ge Cao, Chunxiang Zhou, Yinan Xiong, Xuechen Huang, Jiaoling Luo, Li Int J Environ Res Public Health Article 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. MDPI 2020-02-27 2020-03 /pmc/articles/PMC7084928/ /pubmed/32120925 http://dx.doi.org/10.3390/ijerph17051520 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cao, Xiaolin
Bai, Ge
Cao, Chunxiang
Zhou, Yinan
Xiong, Xuechen
Huang, Jiaoling
Luo, Li
Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017
title Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017
title_full Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017
title_fullStr Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017
title_full_unstemmed Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017
title_short Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017
title_sort comparing regional distribution equity among doctors in china before and after the 2009 medical reform policy: a data analysis from 2002 to 2017
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084928/
https://www.ncbi.nlm.nih.gov/pubmed/32120925
http://dx.doi.org/10.3390/ijerph17051520
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