Comparing Regional Distribution Equity among Doctors in China before and after the 2009 Medical Reform Policy: A Data Analysis from 2002 to 2017

Xiaolin Cao, Ge Bai, Chunxiang Cao, Yinan Zhou, Xuechen Xiong, Jiaoling Huang and Li Luo
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Xiaolin Cao: School of Public Health, Fudan University, Shanghai 200032, China
Ge Bai: School of Public Health, Fudan University, Shanghai 200032, China
Chunxiang Cao: Faculty of Foreign Language, Weifang Medical University, Weifang 261042, Shandong, China
Yinan Zhou: School of Public Health, Fudan University, Shanghai 200032, China
Xuechen Xiong: School of Public Health, Fudan University, Shanghai 200032, China
Jiaoling Huang: School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Li Luo: School of Public Health, Fudan University, Shanghai 200032, China

IJERPH, 2020, vol. 17, issue 5, 1-13

Abstract: Background: Although China began implementing medical reforms in 2009 aimed at fair allocation of the regional distribution of doctors, little is known of their impact. This study analyzed the geographic distribution of doctors from 2002 to 2017. Methods: This study calculated the Gini coefficient and Theil index among doctors in the eastern, central, and western regions (Category 1) of China, and in urban and rural areas (Category 2). The statistical significance of fairness changes was analyzed using the Mann–Whitney U test. Results: The annual growth rates of the number of doctors for the periods from 2002 to 2009 and 2010 to 2017 were 2.38% and 4.44%. The Gini coefficients among Category 1 were lower than those in Category 2, and statistically decreased after the medical reforms (P < 0.01) but continued to increase in Category 2 (P = 0.463). In 2017, the Theil decomposition result of Category 1 was 74.33% for the between-group, and in Category 2, it was 95.22% for the within-group. Conclusions: The fairness among the regional distribution of doctors in Category 1 is now at a high level and is better than that before the reforms. While the fairness in Category 2 is worse than that before the reforms, it causes moderate inequality and is continually decreasing. Overall unfairness was found to be derived from the between-group.

Keywords: equity; doctor resources; time trends (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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