Study On Demand And Supply For Health Resources During 14th Five-Year Plan In China

BackgroundAt present,China’s medical reform has entered the deep-water area.The balance of supply and demand of health resources is facing more complex challenges than ever before,which means not only total amount,but also the balance among health institutions at all levels.From the perspective of supply,during the 12th the 13th five-year plan(2011-2015 and 2016-2020),Chinese governments invested a lot of resources to improve the accessibility of health services,and the supply of doctors and sickbeds increased significantly.From the perspective of demand,with the growth of China’s total population,the aging of population and the continuous improvement of people’s health awareness,the Chinese people’s demand for health services has increased rapidly.From the perspective of policy environment,the hierarchical medical system reform has been implemented since 2015,which would significantly affect the resource allocation pattern.However,most of the existing studies focus on the supply of health resources but not the health demand from Chinese population.This study aims to predict and analyzes the supply and demand of doctors and sickbeds in China during the 14th five-year plan.ObjectivesThe main aim of this study is to estimate the demand for doctors and sickbeds of all population in China during the 14th five-year plan period,and predict the supply of doctors and sickbeds in the same time period.Then,by comparing the total demand,supply and the distribution structure of these health resources between hospitals and primary care institutions,this study provides quantitative data for 14th five-year plan policy.MethodsThis is a highly quantitative study.The average growth rate model is used to predict the changes of China’s total population during the 14th five-year plan period.Based on the existing data structure,a combined model of health demand method and trend extrapolation method is constructed and used to calculate the demand of Chinese residents for doctors and sickbeds.The trend extrapolation method is used to predict the supply of doctors and sickbeds in China during the 14th five-year plan period.ResultsFrom 2021 to 2025,the total demand of Chinese population for doctors is 3.70 million,3.74 million,3.80 million,3.83 million and 3.90 million.The demand for sickbeds is 6.37 million,6.43 million,6.48 million,6.53 million and 6.58 million.The supply size of doctors in China is 3.79 million,3.94 million,4.10 million,4.25 million and 4.40 million.The supply size of sickbeds is 9.34 million,9.77 million,10.20 million,10.63 million and 11.06 million.During the 14th five-year plan period,the demand for hospital doctors ranges from 2.13 million to 2.36 million,and the demand for primary care institutes doctors ranges from 1.57 million to 1.53 million.The demand for hospital sickbeds ranges from 5.30 million to 5.65 million,and the demand for sickbeds in primary care institutes ranges from 1.08 million to 0.93 million.The supply of doctor in hospitals ranges from 2.35 million to 2.76 million,and the supply of doctor primary care institutes ranges from 1.44 million to 1.64 million.The supply of hospital sickbeds ranges from 7.5921 million to 9.0935 million,and the supply of sickbeds in primary care institutes ranges from 1.75 million to 1.96 million.By comparing the supply and demand,this study finds the supply and demand of doctors maintain basic balance during 14th five-year plan period,while the supply of sickbeds greatly exceeded the demand.Therefore,3.25 doctors and up to 6 sickbeds per thousand population could be appropriate goals for China by the end of 14th five-year plan period.Discussion and Policy SuggestionsDiscussion1.14th five-year plan period,the demand for health services of residents in China increased rapidly,and inclined to chronic disease care,geriatric disease care and maternal and child care.From the perspective of supply-demand balance,the supply and demand of doctors in China will show a "tight balance",while the supply of beds will obviously exceed the demand.Although China’s health service supply has basically met the demand in terms of total amount,the structural contradiction between supply and demand,the regional gap in resource allocation and the gap between urban and rural areas still exist.2.The hierarchical medical system policies promoted more patients choose primary care institutes as first-visit institutes.These policies also strengthened the linkage between medical institutions at different levels.However,the hierarchical medical system policies have not changed the trend of relative weakening of primary care institutes.Policy Suggestions1.Release residents’ reasonable demand for health services and control unreasonable demand and utilization:during the 14th five-year plan period,on the one hand,the government should promote the release of residents’ reasonable demand for health services and ensure the sustainable development of people’s health level;On the other hand,government should also start from both sides of supply and demand to control unreasonable demand and utilization,and curb the growth of total health expenses and the health damage caused by excessive medical treatment.2.Pay equal attention to quantity and quality on health human resources:the government should pay equal attention to quantity and quality on development of health human resources.The government and society should further improve the medical education system and strengthen the training of on-the-job personnel and improve their post competence.3.Control the growth of sickbeds during 14th five-year plan period:during 14th five-year plan period,the growth of beds in medical institutions,especially in hospitals,should be restrained.We also suggest to improve the payment method,strengthen the fee control mechanism of medical insurance,and curb unreasonable medical needs.4.Promote the allocation of resources to the primary care system:14th five-year plan period,the government should make greater efforts to implement the hierarchical medical system policies.5.Strengthen demand side investigation and improve health need and demand prediction methods:researchers should fully investigate the needs of countries,regions or medical institutions for health manpower and sickbed allocation,so as to provide practical and effective reference and basis for regional health planning and health human resource allocation through prediction.