title: Inequality trends of health workforce in different stages of medical system reform (1985-2011) in China.
abstract: BACKGROUND
  The aim of this study was to identify whether policies in different stages of medical system reform had been effective in decreasing inequalities and increasing the density of health workers in rural areas in China between 1985 and 2011.
  
  
  METHODS
  With data from China Health Statistics Yearbooks from 2004 to 2012, we measured the Gini coefficient and the Theil L index across the urban and rural areas from 1985 to 2011 to investigate changes in inequalities in the distributions of health workers, doctors, and nurses by states, regions, and urban-rural stratum and account for the sources of inequalities.
  
  
  RESULTS
  We found that the overall inequalities in the distribution of health workers decreased to the lowest in 2000, then increased gently until 2011. Nurses were the most unequally distributed between urban-rural districts among health workers. Most of the overall inequalities in the distribution of health workers across regions were due to inequalities within the rural-urban stratum.
  
  
  CONCLUSIONS
  Different policies and interventions in different stages would result in important changes in inequality in the distribution of the health workforce. It was also influenced by other system reforms, like the urbanization, education, and employment reforms in China. The results are useful for the Chinese government to decide how to narrow the gap of the health workforce and meet its citizens' health needs to the maximum extent.
authors.affiliation: Department of Aerospace Health Services, Fourth Military Medical University, Xi'an, Shaanxi Province, China. csnrzky@126.com.
authors.forename: Kaiyuan
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Department of Otolaryngology, Xi'an Children Hospital, Xi'an, Shaanxi Province, China. xinyidodo@163.com.
authors.forename: Xinyi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China. dingyi.007@163.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. Duolao.Wang@lstm.ac.uk.
authors.forename: Duolao
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Health Services, Fourth Military Medical University, Xi'an, Shaanxi Province, China. 770427955@qq.com.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Health Services, Academy of Military Medical Sciences, Beijing, China. myu@fmmu.edu.cn.
authors.forename: Min
authors.initials: M
authors.lastname: Yu
mesh_terms: D002681:China; D018166:Health Care Reform; D006297:Health Services Accessibility; D006280:Health Workforce; D054625:Healthcare Disparities; D006801:Humans; D009726:Nurses; D010820:Physicians; D019035:Rural Health Services; D012424:Rural Population; D012959:Socioeconomic Factors