Evaluation On Equity And Utilization Efficiency Of Health Resources Allocation In Henan Province Since The New Healtlh Care Reform

Objective:To understand the situation of health resources allocation and utilization in Henan Province in 2009-2014 and conduct the horizontal and vertical assessment of fairness and utilization efficiency of health resources allocation in Henan since the new health care reform, so as to provide statistical basis for allocation of health resources, enhance the fairness, rationality and effectiveness of resources allocation, spur the scientific development of the health cause in Henan province and improve the health status of the general public.Methods:Taking the health resources in Henan Province as the object of study, use the Gini coefficient, Lorenz curve and Theil index to analyze the fairness of allocation of health resources in Henan province; use the data envelopment analysis(DEA) method to conduct the vertical and horizontal evaluation of the efficiency of health resources allocation in Henan Province.Results:1. Basic situation of the allocation and utilization of health resources in Henan Province(1) By the end of 2014, there are a total of 494537 health technicians in the province, 71157 health institutions(including village clinics), 437510 beds at health agencies. In 2009-2014, the annual average growth rate of the number of health workers, number of health technicians and the number of beds in Henan Province were 11.37%, 7.38% and 8.72%. In 2009-2014, the total health expenditure, government expenditure on health, expenditure on social health and personal health expenditure in Henan province witnessed a momentum of growth, and the average annual growth rates were15.17%, 17.65%, 18.31% and 11.49%. Per capita health expenditure increased from 977.33 yuan in 2009 to1991.07 yuan in 2014, an increase of 103.73%, it is below the national average.(2) In 2009-2014, the total diagnosis and total number of discharged patients at the medical and health organizations in Henan province increased year by year; the daily average diagnosis for each doctor and the daily average hospitalization day for each doctor show an upward trend but are lower than the national average level; the utilization of hospital beds and the number of turnover of hospital beds rise continuously, while the number of health centers show an overall downward trend.2. Fairness analysis of health resources allocation in Henan ProvinceIn 2009-2014, the health institutions and health workers in 18 cities in Henan Province are fairly distributed on the basis of the population distribution and are less than 0.3. The Gini coefficient of beds, health personnel and practicing(assistant) doctors is less than 0.2 for six consecutive years; the Gini coefficient of hospital beds in the province has small fluctuations, but is less than 0.1, demonstrating the sound fairness. Geography fairness for health resource allocation is significantly lower than the population fairness, but is basically below 0.4. Only the Gini coefficient of registered nurse almost to 0.4 in 2014, demonstrating poor fairness but still within a reasonable range. Meanwhile, except that the contribution rate of differences inside the health institutions is the same as the contribution rate of the interval differences, the interval difference of remaining health resources(beds, health workers, doctors, nurses) has a far higher contribution rate to the overall difference than the differences inside the region.3. Efficiency evaluation of health resources allocation in Henan ProvinceThe efficiency of health resource allocation in Henan province shows a good utilization efficiency. Only in the year of 2012 is non-DEA year. In 2014, out of 18 cities in the province, there are 9 cities reach relative efficiency in the overall efficiency of health resource allocation, while the efficiency of health resources allocation in other 9 other cities was not valid overall.Conclusions:The total amount of health resources in Henan Province increases every year, but the per capita resources are lower than the national average over the same period; the fairness of allocation of health resources in the province in 2009-2014 showed an overall upward trend. The utililzation of health resources was efficient.