School of Public Administration, Northwest University, Xian, Shanxi, China.
School of Humanities and Social Sciences, Guangxi Medical University, Nanning, China.
Front Public Health. 2024 Sep 6;12:1436244. doi: 10.3389/fpubh.2024.1436244. eCollection 2024.
In China, as people's standard of living improves and the medical service system becomes more sophisticated, the demand for higher-quality and improved healthcare services is steadily rising. Inequality in health resource allocation (HRA) is more pronounced in ethnic minority areas (EMAs) than in developed regions. However, little research exists on high-quality medical resources (HQMRs) in China's EMAs. Hence, we examined the spatiotemporal dynamic evolution of HQMRs in China's EMAs from 2007 to 2021 and identified the main factors affecting their respective HQMR levels.
We selected tertiary hospitals to represent the quality of healthcare resources. We employed descriptive statistical techniques to analyze changes in the distribution of HQMRs from 2007 to 2021. We used the Dagum Gini coefficient and kernel density approach to analyze the dynamic evolution of HQMRs in China's EMAs. We utilized the least squares dummy variable coefficient (LSDVC) to identify key factors affecting HQMR.
The number of HQMRs in each EMA has risen annually. The average number of tertiary hospitals increased from 175 in 2007 to 488 in 2021. The results of the Dagum Gini coefficient revealed that the differences in the HQMR level in China's EMAs have slowly declined, and intra-regional disparities have now become the primary determining factor influencing overall variations. The kernel density plot indicated that the HQMR level improved significantly during the study period, but bifurcation became increasingly severe. Using the LSDVC for analysis, we found that gross domestic product (GDP) , the size of the resident population, and the number of students enrolled in general higher education exhibited a significant negative correlation with HQMR levels, while GDP and urbanization rate had a significant promoting effect.
The HQMR level in EMAs has risen rapidly but remains inadequate. The differences in HQMR between regions have continued to narrow, but serious bifurcation has occurred. Policymakers should consider economic growth, education, and population size rather than simply increasing the number of HQMRs everywhere.
在中国，随着人们生活水平的提高和医疗服务体系的日益完善，对更高质量和改进的医疗服务的需求稳步上升。少数民族地区（EMAs）的卫生资源分配不平等程度比发达地区更为明显。然而，中国少数民族地区高质量医疗资源（HQMRs）的研究甚少。因此，我们考察了 2007 年至 2021 年中国少数民族地区 HQMR 的时空动态演变，并确定了影响各自 HQMR 水平的主要因素。
我们选择三级医院来代表医疗资源质量。我们采用描述性统计技术分析了 2007 年至 2021 年 HQMR 分布的变化。我们使用 Dagum Gini 系数和核密度方法分析了中国少数民族地区 HQMR 的动态演变。我们利用最小二乘虚拟变量系数（LSDVC）来识别影响 HQMR 的关键因素。
每个少数民族地区的 HQMR 数量都在逐年增加。三级医院的平均数量从 2007 年的 175 所增加到 2021 年的 488 所。Dagum Gini 系数的结果表明，中国少数民族地区 HQMR 水平的差异缓慢下降，区域内差异现在成为影响整体变化的主要因素。核密度图表明，在研究期间，HQMR 水平显著提高，但分叉变得越来越严重。通过 LSDVC 分析，我们发现国内生产总值（GDP）、常住人口规模和普通高等教育招生人数与 HQMR 水平呈显著负相关，而 GDP 和城市化率对 HQMR 水平有显著的促进作用。
少数民族地区 HQMR 水平迅速提高，但仍显不足。地区间 HQMR 差异继续缩小，但严重的分叉现象已经出现。政策制定者应考虑经济增长、教育和人口规模，而不仅仅是在各地增加 HQMR 的数量。
