| The paper aims to summarize the current status of health resources in China as well as the world, investigate the ratio of Chinese health resources in the world regarding the Total Health Expenditure, health workforce and hospital beds, identify health resource index and evaluate the extent of Chinese health resource in the world, thereafter conduct comprehensive evaluation of Chinese health resource from the global perspective, analyze existing problems and shortages of health resource investment in China, and finally put forward policy recommendations to promote development of health resources in China.Methods:Literature review, comparative study, trend extrapolation and statistical methods were applied in this paper to analyze following indicators:the ratio of Chinese health expenditure, health personnel, hospital beds, population and GDP in the world from1995to2011. Health resource index was established and RSR method was applied for comprehensive analysis of health resources in China. Main statistical tools including Excel、SAS and SPSS17.0were applied in the study.Results and analysis:The ratio of Chinese Total Health Expenditures in the world kept on the rise, increased from0.98%in1995to4.50%in2010(based on USD with current exchange rate), with an average annual growth of10.70%.Considering purchasing power parity (PPP), this ratio increased from2.26%in1995to6.35%in2010, with an average annual growth of7.13%.The GDP and population of China accounted for 9.39%(13.24%in PPP) and19.45%respectively in the world. The ratio of China’s Total Health Expenditures in the world was much lower than the ratio of GDP or population. China’s investment in Total Health Expenditures fell far behind developed countries and BRICS countries, such as Russia and Brazil.The ratio of Chinese health workforce in the world increased by2.09percentage points, with an annual growth of4.03%between2006and2010. The ratio of Chinese health workforce was higher than the ratio of China’s economy, but lower than the ratio of China’s population in the world. Excluding the impact of population or economy, the ratio of Chinese health workforce in the world ranked7th and5th respectively in eight major economies including China, Russia, India, Brazil, the United Kingdom, the United States, Japan and Germany.The ratio of China’s hospital beds in the world increased from21.00%in2007to25.83%in2011. In2011, China’s GDP and population accounted for10.45%(13.96%in PPP) and19.32%respectively in the world, lower than the ratio of China’s hospital beds (25.83%). With consideration of population, China ranked4th in the eight major economies, higher than BRIC countries, United States and the United Kingdom. With consideration of economy, China would be ranked1st in the eight major economies.Health resource index was established for China according to "United Nations human development index building guide". The result indicated that China’s comprehensive health resource index was0.24, ranking125th among224countries. The result was verified by comprehensive evaluation of Chinese health resources based on RSR method which demonstrated that China ranked125th in the world. No significant difference was found between the two methods by non-parameter test.Discussion:The ratio of Chinese health resource in the world is analyzed in the study, which proves that the saying that "China provided accessible health services to22%of global population with2%of global health resources" is deviating from the fact. The two ratios never appear in analysis of health financing, health workforce or health resources at the same time. Therefore, the incorrect allegation should be clarified to avoid misleading information for the public, guidance of research conduct and decision making.The ratio of China’s Total Health Expenditure in the word keeps on the rise in recent years. However, China’s Total Health Expenditure, ratio in the world and per capital health expenditure is still at a low level compared to China’s largest population and second largest economic size in the world, demonstrating disparity between health financing and socioeconomic development and public needs in China. Compared to the developed countries, China still lacks sufficient health resources and has higher out-of-pocket payment ratio (about35%in2011).The ratio of Chinese health workforce in the world has been increasing gradually. The ratio is higher than the share of China’s economic size in the world, but lower than the ratio of China’s population in the world. China still falls behind other BRICS countries with regard to health workforce per economic size or population. Further studies indicate that the ratio of China’s physicians in the world is gradually increasing, consistent with the share of China’s economic size and population in the world. However, China is still short of nurses and midwives, inconsistent with the share of China’s economic size and population in the world.The number of hospital beds in China has been increasing in recent years, as well as its ratio in the world. China has more hospitals beds, more per capita hospital beds and higher proportion of hospital beds in the world than most BRICS countries and even some developed countries. With higher ratio of hospital beds than ratio of economic size/population in the world, China has enough hospital beds to meet public health needs.China’s investment in health resources is lower than the investment of other BRICS countries and developed countries, ranking125th in the world and7th in the eight-country group.Suggestion:It is suggested that health policy and management should be implemented based on evidence-based researches.The scale of Chinese Health Expenditures and public share should be scaled up to match with the GDP and population development.Stable increase of Total Hhealth Expenditure should be achieved to increase the ratio of Chinese Health Expenditure in the world. Necessary training should be provided for more health workforce to meet public needs. Furthermore,utilization of health resources should be improved while controlling increase of hospital beds to ensure coordinated development of health, economy and population. |
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