Cargando…
Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources
BACKGROUND: China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China’s health resources over the past ten years after the healthcare reform. METHODS...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670033/ https://www.ncbi.nlm.nih.gov/pubmed/34903184 http://dx.doi.org/10.1186/s12889-021-12248-9 |
_version_ | 1784614897081909248 |
---|---|
author | Chen, Jiang Lin, Zhuochen Li, Li-an Li, Jing Wang, Yuyao Pan, Yu Yang, Jie Xu, Chuncong Zeng, Xiaojing Xie, Xiaoxu Xiao, Liangcheng |
author_facet | Chen, Jiang Lin, Zhuochen Li, Li-an Li, Jing Wang, Yuyao Pan, Yu Yang, Jie Xu, Chuncong Zeng, Xiaojing Xie, Xiaoxu Xiao, Liangcheng |
author_sort | Chen, Jiang |
collection | PubMed |
description | BACKGROUND: China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China’s health resources over the past ten years after the healthcare reform. METHODS: Data were collected from the China Statistical Yearbook and China Health Statistics Yearbook from 2009 to 2018. Four categories and ten indicators of health resources were analyzed. A descriptive analysis was used to present the overall condition. The Health Resource Density Index was applied to showcase health-resource distribution in demographic and geographic dimensions. The global and local Moran’s I were used to assess the spatial autocorrelation of health resources. Concentration Index (CI) was used to quantify the equity of health-resource distribution. A Geo-Detector model and Geographic Weighted Regression (GWR) were applied to assess the association between gross domestic product (GDP) per capita and health resources. RESULTS: Health resources have increased over the past ten years. The global and local Moran’s I suggested spatial aggregation in the distribution of health resources. Hospital beds were concentrated in wealthier areas, but this inequity decreased yearly (from CI=0.0587 in 2009 to CI=0.0021 in 2018). Primary medical and health institutions (PMHI) and their beds were concentrated in poorer areas (CI remained negative). Healthcare employees were concentrated in wealthier areas (CI remained positive). In 2017, the q-statistics indicated that the explanatory power of GDP per capita to beds, health personnel, and health expenditure was 40.7%, 50.3%, and 42.5%, respectively. The coefficients of GWR remained positive with statistical significance, indicating the positive association between GDP per capita and health resources. CONCLUSIONS: From 2009 to 2018, the total amount of health resources in China has increased substantially. Spatial aggregation existed in the health-resources distribution. Health resources tended to be concentrated in wealthier areas. When allocating health resources, the governments should take economic factors into account. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12248-9. |
format | Online Article Text |
id | pubmed-8670033 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86700332021-12-15 Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources Chen, Jiang Lin, Zhuochen Li, Li-an Li, Jing Wang, Yuyao Pan, Yu Yang, Jie Xu, Chuncong Zeng, Xiaojing Xie, Xiaoxu Xiao, Liangcheng BMC Public Health Research BACKGROUND: China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China’s health resources over the past ten years after the healthcare reform. METHODS: Data were collected from the China Statistical Yearbook and China Health Statistics Yearbook from 2009 to 2018. Four categories and ten indicators of health resources were analyzed. A descriptive analysis was used to present the overall condition. The Health Resource Density Index was applied to showcase health-resource distribution in demographic and geographic dimensions. The global and local Moran’s I were used to assess the spatial autocorrelation of health resources. Concentration Index (CI) was used to quantify the equity of health-resource distribution. A Geo-Detector model and Geographic Weighted Regression (GWR) were applied to assess the association between gross domestic product (GDP) per capita and health resources. RESULTS: Health resources have increased over the past ten years. The global and local Moran’s I suggested spatial aggregation in the distribution of health resources. Hospital beds were concentrated in wealthier areas, but this inequity decreased yearly (from CI=0.0587 in 2009 to CI=0.0021 in 2018). Primary medical and health institutions (PMHI) and their beds were concentrated in poorer areas (CI remained negative). Healthcare employees were concentrated in wealthier areas (CI remained positive). In 2017, the q-statistics indicated that the explanatory power of GDP per capita to beds, health personnel, and health expenditure was 40.7%, 50.3%, and 42.5%, respectively. The coefficients of GWR remained positive with statistical significance, indicating the positive association between GDP per capita and health resources. CONCLUSIONS: From 2009 to 2018, the total amount of health resources in China has increased substantially. Spatial aggregation existed in the health-resources distribution. Health resources tended to be concentrated in wealthier areas. When allocating health resources, the governments should take economic factors into account. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12248-9. BioMed Central 2021-12-13 /pmc/articles/PMC8670033/ /pubmed/34903184 http://dx.doi.org/10.1186/s12889-021-12248-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Chen, Jiang Lin, Zhuochen Li, Li-an Li, Jing Wang, Yuyao Pan, Yu Yang, Jie Xu, Chuncong Zeng, Xiaojing Xie, Xiaoxu Xiao, Liangcheng Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources |
title | Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources |
title_full | Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources |
title_fullStr | Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources |
title_full_unstemmed | Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources |
title_short | Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources |
title_sort | ten years of china’s new healthcare reform: a longitudinal study on changes in health resources |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670033/ https://www.ncbi.nlm.nih.gov/pubmed/34903184 http://dx.doi.org/10.1186/s12889-021-12248-9 |
work_keys_str_mv | AT chenjiang tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT linzhuochen tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT lilian tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT lijing tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT wangyuyao tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT panyu tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT yangjie tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT xuchuncong tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT zengxiaojing tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT xiexiaoxu tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources AT xiaoliangcheng tenyearsofchinasnewhealthcarereformalongitudinalstudyonchangesinhealthresources |