Examining the Multi-Scalar Unevenness of High-Quality Healthcare Resources Distribution in China

Meng Yu, Shenjing He, Dunxu Wu, Hengpeng Zhu and Chris Webster
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Meng Yu: Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
Shenjing He: Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
Dunxu Wu: Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
Hengpeng Zhu: Public Policy Research Center, Chinese Academy of Social Sciences, Beijing 100732, China
Chris Webster: Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China

IJERPH, 2019, vol. 16, issue 16, 1-20

Abstract: Healthcare disparity is, to a large extent, ascribable to the uneven distribution of high-quality healthcare resources, which remains insufficiently examined, largely due to data unavailability. To overcome this barrier, we synthesized multiple sources of data, employed integrated methods and made a comprehensive analysis of government administrative structures and the socio-economic environment to build probably the most inclusive dataset of Chinese 3-A hospitals thus far. Calibrated on a sample of 379 hospitals rated by a reputable organization, we developed a realistic and viable evaluation framework for assessing hospital quality in China. We then calculated performance scores for 1246 3-A hospitals, which were aggregated and further analyzed at multiple scales (cities, provinces, regions, and economic zones) using general entropy indexes. This research shows that the fragmented governance and incoordination of “ kuai ” and “ tiao ” is rooted deeply in China’s legacy of centrally-planned systems, and has had a far-reaching yet partially contradictory influence over the contemporary distribution and performance of healthcare resources. Additionally, the unevenness in the distribution of healthcare resources is related closely to a city’s administrative rank and power. This study thus suggests that the policy design of healthcare systems should be coordinated with external socio-economic transformation in a sustainable manner.

Keywords: high-quality healthcare resources; evaluation framework; 3-A hospitals; hospital quality; general entropy indexes; multi-scalar unevenness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (7)

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