Analysis Of Health Human Resources Allocation And Fairness In Henan Province From 2011 To 2017

Objective:This study aims to understand the current situation of health manpower allocation in Henan Province from 2011 to 2017,analyze the fairness and trend of the allocation,find out the main problems in the current health manpower allocation,and explore the strategies to optimize the health manpower allocation.In this sense,this study can provide scientific evidence for the policy-making of the health manpower,promote the high-quality and balanced development of the health workforce,and provide manpower support for the construction of the “Healthy Central Plains” in the new era.Methods:The descriptive statistical methods were used to analyze the current situation of the number,distribution,and structure of health manpower in Henan Province from 2011 to 2017.A comprehensive methodology of Gini coefficient,Theil index,and concentration index was used to evaluate the fairness and trend of health manpower allocation in Henan Province.Results:1.The Present Situation of Health Manpower Allocation in Henan ProvinceThe total number of health workers in Henan Province continued to grow rapidly in 2011-2017,but the number of rural doctors decreased year by year.Among health technicians,registered nurses had the fastest speed of growth,and the inversion of the proportion of doctors and nurses was reversed since 2014.The number of health technicians per 1,000 persons had reached the average level in the central region,but it was still below the national average.Health technicians were mainly concentrated in hospitals,while primary medical institutions accounted for a small proportion.From the perspective of health technicians per 1,000 persons,the city was higher than the rural areas,and the northern regions were generally higher than the southern regions.The provincial capital Zhengzhou was significantly higher than other provincial cities.The structure of educational background in health technicians had been continuously improved,but the level of professional titles was relatively lagging.The proportions of high-level academics and senior professional titles were small.Compared with the average level of the nation,there was still a large gap.2.Fairness of Health Manpower Allocation in Henan Province(1)Analysis of fairness based on Gini coefficientAccording to the population distribution,the Gini coefficients of various types of health personnel in 2011-2017 were below 0.2,and the Lorenz curve was less curved,indicating that the fairness of population distribution was highly fair.The practicing(assistant)physicians and registered nurses were geographically distributed.The Gini coefficient was between 0.3 and 0.4.The Gini coefficient based on geographical distribution among pharmacists,technicians,and ruraldoctors was between 0.2 and 0.3.The Lorenz curve was largely curved,indicating that the fairness based on geographical distribution was relatively poor.Regardless of the population distribution or the geographical distribution,the fairness of registered nurses was the worst,and the fairness of rural doctors was the best.In the past seven years,the Gini coefficient of Henan's manpower allocation increased with a wave,but the range of change was not large.(2)Analysis of fairness based on the Theil indexThe Theil index for all types of health personnel allocation in 2011-2017 showed a slight increase.There was the highest Theil index in the registered nurses and the relatively small Theil index in the rural doctor's.After decomposing the total Theil index,we found that the imbalance in the configuration of practicing(assistant)physicians and registered nurses was mainly caused by the interval differences,and the imbalance among pharmacists,technicians,and rural doctors was mainly caused by the intraregional differences.In the past 7 years,the contribution rate of the interval difference to the total Theil index had decreased.(3)Analysis of fairness based on concentration indexThe concentration index of all types of health personnel allocation in 2011-2017 was less than 0.2 and was positive,indicating that the health workforce was relatively concentrated in the areas with high economic development level.However,the concentration index was small,which indicated that the differences of the allocation of health workforce were not obvious in different areas with different economic levels.Among all types of health workers,registered nurses had the highest concentration index,and rural doctors had the lowest concentration index.In the past seven years,the concentration index of practicing(assistant)physicians,registered nurses,pharmacists,and technicians had changed little;the concentration index of rural doctors had declined year by year.Conclusions:In 2011-2017,the total number of health human resources in Henan Province is still relatively insufficient,and the structure and distribution need to be further optimized.The health manpower in Henan Province is less fair according to geographical distribution.The impact of regional differences on the fairness of health workforce is declining.The allocation of health workforce tends to be high in areas with high economic level.