The Study On Equity And Efficiency Of Health Resources Allocation In Gansu Province

Objectives Unfair and inefficiency allocation of health resources restricted the health development severely; health resource allocation status seriously influenced the developing area residents’benefits and the social progress. Therefore, equity and efficiency are primary problems which must be solved in order to achieve the optimal allocation of health resources and improve the health of all people. To reveal the equity and efficiency of health resources allocation based on describing health resource allocation’s basic situation and comprehensive evaluation of equity and efficiency in Gansu Province, so as to provide reference basis on optimizing allocation of health resources, making regional health development planning, and to promote the reasonability, fairness and effectiveness of health resource allocation in Gansu, ultimately achieving the health sustainable development goals.Methods Excel2007, SPSS18.0and Matlab7.0were applied for data processing; descriptive analysis method was used to analyze the allocation and utilization of health resources; adopting Lorenz curves, Gini coefficient and Theil index were used to analyze the fairness; Data envelopment analysis (DEA) was used for comprehensive evaluation.Results1. The basic conditions of health resource allocation and utilization efficiency in Gansu Province was as follows:(1) By the end of2011, the total number of health technical personnel was106,252in Gansu, with an increase of8865over the previous year, and the growth rate was9.1%; health institutions (including village hospitals) were19292, and more336than last year, with an increase of1.77%; patients beds were101,068, and an increase of10,698over last year. From2007to2011, the annual average growth rates of health personnel, health technical personnel and patient beds were24.26%,25.68%and7.82%respectively. The total health expenditure, the government health spending, social spending on health services and personal healthy expense were all increased year by year, and the growth rate were39.87%,34.43%and17.38%respectively; the personal healthy expense increased from562.27RMB in2007to1535RMB in2011as increasing by1.7times, but it was still lower than the national average level. (2) From2007to2011, the number of out-patients and discharged-patients had been increasing yearly; daily average rate of outpatient visits and in-patient cares per doctor were decreased before increased, and less than the average level in2011; the utilization rate of beds and the turnover of beds in hospital increased yearly, but in community hospital the data all went up firstly, and then decreased; the health expenditures per inpatients and outpatients increased year by year, and the average growth rates were14.32%and11.52%respectively.2. Analysis on the equity of health resources allocation in Gansu ProvinceFrom2007to2011, the equity of the health institutions and health personnel resources was growing according to the population distribution. In2007, the Gini coefficient of patient beds determined by the population distribution was0.4652which was poor fairness, and then improved gradually; however, the equity of health resources according to the geographic distribution was poorer. The population fairness of health resource allocation was superior to the geographic fairness in Gansu. Meanwhile, in addition to inside interval gap in health institutions was greater than the interval gap, and the interval difference of other health resources (beds, health personnel, doctors, nurses) were far higher than the inside interval. At the same time, five regional differences were greater than the inside regional differences in the health resources allocation.3. Evaluation the efficiency of health resources allocation in Gansu ProvinceThe efficiency of the health resources allocation was gradually increasing in general, and got the minimum in2007, then improved gradually from2009to2011, and the efficiency of resource allocation had reached a relatively effective. However, the health resources allocation efficiency was imbalance in every state. Only three cities’ health resource allocation efficiency were relatively effective, while other11cities’ allocation efficiency were non-overall effect, and the allocation efficiency of11other cities were non-effective.Conclusions(1) The total amount of health resources in Gansu Province gradually increased, but the per capita resources were lower than the national average over the same period;(2) The population fairness of health resource allocation was superior to the geographic fairness in Gansu, and the geographical fairness was very poor, which exceeded the state of alert. At the same time, there were great differences between regions;(3) The utilization efficiency of health resources had increased, but the outpatient utilization of resources was lower, and the health resources allocation efficiency among the regions still existed differences;(4) Each local government’s investment in health area was insufficient and per medical expense was increasing every year.