| Objective: To identify the existing problems in the current allocation of health resources in Qinghai Province according to the analysis on the status and equity of allocation of health resources in Qinghai Province from 2011 to 2014. In addition to the optimal allocation of health resources, the reasonable suggestions are also proposed to improve the equity of allocation of health resources and the policy references are provided for the local government and departments concerned to prepare the regional health planning, which can improve the health of people and thus drive the development of health service in Qinghai Province to the coordinated and sustainable direction.Methods: The research methods in this paper included the document retrieval,descriptive analysis and quantitative research. The document retrieval and descriptive analysis were employed to introduce the social and economic situation and analyze the status of allocation of health resources in Qinghai Province; the economic methods, namely Lorenz curve, Gini coefficient and Theil index, were adopted to evaluate the equity of allocation of health resources in Qinghai Province; and the quantitative research was used to analyze the equity of allocation of health resources regarding the population distribution and geographical distribution and the difference between regions in Qinghai Province from 2011 to 2014.Results:1. Status of Allocation of Health Resources in Qinghai Province(1) The indexes of human resources for health were increased steadily: the human resources for health in Qinghai Province were increased year by year from 2011 to2014, where the number of health personnel was increased from 31,036 in 2011 to38,673 in 2014, with the annual growth rate of 6.15%; the number of health professionals from 26,132 in 2011 to 33,138 in 2014, with the annual growth rate of6.70%; the number of registered nurses from 9,368 in 2011 to 12,961 in 2014, with the annual growth rate of 9.56%; the number of practicing(assistant) physicians was gradually increased from 2011 to 2013, but a bit decreased in 2014 from 12,069 to11,960, with the annual growth rate of 4.82% in four years.(2) The material resources for health were increased year by year: The number of medical institutions was increased by 351 from 5,890 in 2011 to 6,241 in 2014, where the number of hospitals, grass-root health facilities and public health facilities were also increased. The number of beds in medical institutions was increased by nearly10,000 from 23,171 in 2011 to 33,107 in 2014. The number of beds per 1000 population was increased from 4.18 in 2011 to 5.71 in 2014 in Qinghai Province,which was a bit higher than the national level over the same period. But there was the large gap compared with the one in some developed cities.(3) The total health expenditure was gradually increased in Qinghai Province, but the expenditure per person was lower than the national level: The total health expenditure was increased by RMB 39.09732 million Yuan from RMB 561.57330 million Yuan in 2011 to RMB 952.54650 million Yuan in 2014 in Qinghai Province;while the expenditure per person was increased year by year from RMB 1007.15 Yuan in 2011 to RMB 1641.86 Yuan in 2014, but there was the certain gap compared with the national level. There was the significant difference in the income and expenditure of medical institutions among regions in Qinghai Province.2. Equity of Allocation of Health Resources in Qinghai Province(1) Analysis on Equity of Allocation of Health Resources in Qinghai Province using Gini Coefficient The equity of allocation of health resources regarding the population distribution in Qinghai Province was relatively good: The curvature of Lorenz curve was small and it was close to the absolute equity line. The Gini coefficient of human resources for health was less than 0.4, which indicated that the human resources for health was in the normal state regarding the population distribution. The equity of the number of beds in the medical institutions regarding the population distribution was relatively good. Where, the curvature of Lorenz curve was small and it was close to the absolute equity line. Its Gini coefficient was less than 0.3, which indicated that it was in the optimal average state.The equity of allocation of health resources regarding the geographical distribution in Qinghai Province was relatively poor: The curvature of Lorenz curve was large and it was deviated from the absolute equity line. The Gini coefficient of health resources was between 0.6-0.8, which indicated that the human resources for health regarding the geographical distribution was in the dangerous state of absolute inequity state.(2) Analysis on Equity of Allocation of Health Resources in Qinghai Province using Theil Index The total Theil index of human resources for health was relatively small, where the Theil index of registered nurse was higher than other indexes. By decomposing the total Theil index, the inter-regional contribution rate was large and the intra-regional contribution rate was small, which indicated that the allocation of human resources for health was unbalanced, with the main reason of difference among regions. The total Theil index of the number of beds in medical institutions was also small. By decomposing the total Theil index, the inter-regional contribution rate was large and the intra-regional contribution rate was small, which indicated that the allocation of the number of beds was also unbalanced, with the main reason of difference among regions.Conclusion:(1) The total amount of health resources in Qinghai Province is basically sufficient and shows the trend of constantly increasing. But the allocation of resources is unbalanced.(2) The population equity of allocation of health resources in Qinghai Province is significantly better than the geographical one. The Gini coefficient of health resources regarding the population distribution is in the good average state, while the geographical equity exceeds the risk level, showing the high inequity.(3) The allocation of health resources in Qinghai Province is in the state of equity as a whole. The difference among regions is the main reason for the unbalanced allocation of health resources in Qinghai Province.(4) The total amount of human resources for nursing in Qinghai Province is insufficient and its ratio of physicians and nurses is far lower than the national level of 1:2. The long-term lack of nursing personnel is the key factor to affect the level of medical security in Qinghai Province. |
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