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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2018

Open Access 01-12-2018 | Research

Equity and efficiency of primary health care resource allocation in mainland China

Authors: Yue Zhang, Qian Wang, Tian Jiang, Jian Wang

Published in: International Journal for Equity in Health | Issue 1/2018

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Abstract

Background

China had proposed the unification of equity and efficiency since the launch of the new round of health system reform in 2009. And the central government gave priority to the development of primary health care (PHC) whilst ensuring its availability and improving its efficiency. This study aimed to evaluate the changes of equity and efficiency in PHC resource allocation (PHCRA) and explored ways to improve the current situation.

Methods

The data of this study came from the China Health Statistical Yearbook (2013–2017) and China Statistical Yearbook (2017). Three and five indicators were used to measure equity and efficiency, respectively. The Lorenz curve, Gini coefficient (G), Theil index (T) and health resource density index (HRDI) were used to assess equity in demographic and geographical dimensions. Data envelopment analysis (DEA) and the Malmquist productivity index (MPI) were chosen to measure the efficiency and productivity of PHCRA.

Results

From 2012 to 2016, the total amount of PHCR had increased year by year. The Gs by population size were below 0.2 and that by geographical area were between 0.6 and 0.7. T had the same trend with G, and intra-regional contribution rates were higher than inter-regional contribution rates, which were all beyond 60%. From 2012 to 2016, the numbers of provinces that achieved an effective DEA were 4, 3, 4, 5 and 5, respectively. The mean of the total factor productivity index was 0.994.

Conclusion

The equity of PHCRA in terms of population size is superior in the geographical area. Intra-regional differences are the main source of inequality. The eastern region has the highest density of PHCR, whereas the western region has the lowest. In addition, PHC institutions in more than 80% of the provinces are inefficient, and the productivity of the institutions decline by 0.6% from 2012 to 2016 because of technological retrogression.
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Metadata
Title
Equity and efficiency of primary health care resource allocation in mainland China
Authors
Yue Zhang
Qian Wang
Tian Jiang
Jian Wang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2018
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-018-0851-8

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