China Population and Development Research Center, Beijing, China.
China Center for Health Development Studies, Peking University, Beijing, China.
Int J Health Plann Manage. 2024 Sep;39(5):1551-1561. doi: 10.1002/hpm.3828. Epub 2024 Jul 25.
Since 2009, China has made large investments in strengthening the primary healthcare system. This study aimed to examine the trends in the number and distribution of health resources in rural China following the health system reform and to decompose the sources of inequalities. Data were collected from standardized reports compiled by each county in rural China and compiled by the National Health Commission and Bureau of Statistics. From the findings of this empirical study, resource allocation per capita for primary health care (PHC) improved gradually from 2008 to 2014. The distribution of beds across counties (ranked by level of economic development) was relatively equitable. However, the concentration curve analysis indicated that the distribution of primary care professionals remained skewed in favour of wealthier and more urbanised counties. Economic status was proved to be a major contributor to the inequality of health human resource. China's primary care reforms resulted in simultaneously improved supply of PHC resources as well as pro-rich inequality in distribution of the workforce. To advance equality in health resource allocation, greater attention should be paid to the substantial inequality of economic status within counties.
自 2009 年以来，中国在加强基层医疗体系方面投入了大量资金。本研究旨在考察农村卫生系统改革后卫生资源数量和分布的变化趋势，并分解不平等的来源。数据来自中国农村每个县编制的标准化报告，由国家卫生健康委员会和统计局汇编。从这项实证研究的结果来看，基层医疗保健（PHC）的人均资源配置从 2008 年到 2014 年逐渐提高。按经济发展水平排列的县级床位分布相对公平。然而，集中曲线分析表明，基层医疗专业人员的分布仍然偏向于经济较发达和城市化程度较高的县。经济状况被证明是卫生人力资源不平等的主要原因。中国的基层医疗改革在提高基层医疗资源供给的同时，也加剧了卫生人力资源分配上的贫富不均。为了推进卫生资源配置的公平性，应更加关注县级经济状况的巨大不平等。
