title: Does Rapid and Sustained Economic Growth Lead to Convergence in Health Resources: The Case of China From 1980 to 2010.
abstract: China's rapid and sustained economic growth offers an opportunity to ask whether the advantages of growth diffuse throughout an economy, or remain localized in areas where the growth has been the greatest. A critical policy area in China has been the health system, and health inequality has become an issue that has led the government to broaden national health insurance programs. This study investigates whether health system resources and performance have converged over the past 30 years across China's 31 provinces. To examine geographic variation of health system resources and performance at the provincial level, we measure the degree of sigma convergence and beta convergence in indicators of health system resources (structure), health services utilization (process), and outcome. All data are from officially published sources: the China Health Statistics Year Book and the China Statistics Year Book. Sigma convergence is found for resource indicators, whereas it is not observed for either process or outcome indicators, indicating that disparities only narrowed in health system resources. Beta convergence is found in most indicators, except for 2 procedure indicators, reflecting that provinces with poorer resources were catching up. Convergence found in this study probably reflects the mixed outcome of government input, and market forces. Thus, left alone, the equitable distribution of health care resources may not occur naturally during a period of economic growth. Governmental and societal efforts are needed to reduce geographic health variation and promote health equity.
authors.affiliation: University of California, Los Angeles, USA lesley200712666@sina.com.
authors.forename: Di
authors.initials: D
authors.lastname: Liang
authors.affiliation: University of California, Los Angeles, USA.
authors.forename: Donglan
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Fudan University, Shanghai, People's Republic of China.
authors.forename: Jiayan
authors.initials: J
authors.lastname: Huang
authors.affiliation: University of California, Los Angeles, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Schweitzer
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D001509:Bed Occupancy / Q000706:statistics & numerical data; D002681:China; D057217:Economic Development / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008428:Maternal Mortality; D009313:National Health Programs / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*
keywords: China; convergence; geographic variation; health inequality; health system