National equity of health resource allocation in China: data from 2009 to 2013.
BACKGROUND
The inequitable allocation of health resources is a worldwide problem, and it is also one of the obstacles facing for health services utilization in China. A new round of health care reform which contains the important aspect of improving the equity in health resource allocation was released by Chinese government in 2009. The aim of this study is to understand the changes of equity in health resource allocation from 2009 to 2013, and make a further inquiry of the main factors which influence the equity conditions in China.


METHODS
Data resources are the China Health Statistics Yearbook (2014) and the China Statistical Yearbook (2014). Four indicators were chosen to measure the trends in equity of health resource allocation. Data were disaggregated by three geographical regions: west, central, and east. Theil index was used to calculate the degree of unfairness.


RESULTS
The total amount of health care resources in China had been increasing in recent years. However, the per 10, 000 km(2) number of health resources showed a huge gap in different regions, and per 10, 000 capita health resources ownership showed a relatively small disparities at the same time. The index of health resources showed an overall downward trend, in which health financial investment the most unfair from 2009 to 2012 and the number of health institutions the most unfair in 2013. The equity of health resources allocation in eastern regions was the worst except for the aspect of health technical personnel allocation. The regional contribution rates were lower than that of the inter-regional contribution rates which were all beyond 60 %.


CONCLUSIONS
The equity of health resource allocation improved gradually from 2009 to 2013. However, the internal differences within the eastern region still have a huge impact on the overall equity in health resource allocation. The tough issues of inequitable in health resource allocation should be resolved by comprehensive measures from a multidisciplinary perspective.
Department of Social Medicine and Health Management, College of Public Health, Shandong University, 44 Culture Road, Li Xia District, Jinan, 250012, Shandong Province, China.
Wen
W
Liu
Department of Epidemiology and Biostatistics, College of Public Health, Shandong University, 44 Culture Road, Li Xia District, Jinan, 250012, Shandong Province, China.
Ying
Y
Liu
Department of Social Medicine and Health Management, College of Public Health, Shandong University, 44 Culture Road, Li Xia District, Jinan, 250012, Shandong Province, China.
Peter
P
Twum
Department of Social Medicine and Health Management, College of Public Health, Shandong University, 44 Culture Road, Li Xia District, Jinan, 250012, Shandong Province, China. shixueli@sdu.edu.cn.
Shixue
S
Li
D002681:China; D000069576:Health Equity / Q000592:standards*; D006291:Health Policy / Q000639:trends; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D040841:Resource Allocation / Q000379:methods / Q000592:standards*
Equity; Health care resources; Theil index