Trend in distribution of primary health care professionals in Jiangsu province of eastern China

详细信息    查看全文

• 作者：Kang Xu (1)
  Kaijin Zhang (2)
  Dan Wang (3)
  Ling Zhou (3)
  
  1. Department of Medical Administration ; Huai鈥檃n First People鈥檚 Hospital ; Nanjing Medical University ; 6 Beijing West Road ; Huai鈥檃n ; Jiangsu ; 223300 ; China
  2. School of Public Health ; Southeast University ; 87 Dingjia Bridge ; Nanjing ; Jiangsu ; 210009 ; China
  3. Department of Epidemiology and Biostatistics ; School of Public Health ; Nanjing Medical University ; 818 Tianyuan East Road ; Nanjing ; Jiangsu ; 211166 ; China
  
• 关键词：Primary health care ; Health workforce ; Inequality ; People鈥檚 Republic of China
• 刊名：International Journal for Equity in Health
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：13
• 期：1
• 全文大小：925 KB
• 参考文献：1. Kruk, ME, Porignon, D, Rockers, PC, Lerberghe, W (2010) The contribution of primary care to health and health systems in low- and middle-income countries: a critical review of major primary care initiatives. Soc Sci Med 70: pp. 904-911 nal" href="http://dx.doi.org/10.1016/j.socscimed.2009.11.025" target="_blank" title="It opens in new window">CrossRef
  2. Shi, L, Macinko, J, Starfield, B, Politzer, R, Wulu, J, Xu, J (2005) Primary care, social inequalities and all-cause, heart disease and cancer mortality in US counties: a comparison between urban and non-urban areas. Public Health 119: pp. 699-710 nal" href="http://dx.doi.org/10.1016/j.puhe.2004.12.007" target="_blank" title="It opens in new window">CrossRef
  The World Health Report 2008: Primary Health Care (Now More Than Ever). WHO, Geneva nal" href="http://dx.doi.org/10.1596/978-0-8213-7675-1" target="_blank" title="It opens in new window">CrossRef
  3. Rohde, J, Cousens, S, Chopra, M, Tangcharoensathien, V, Black, R, Bhutta, ZA, Lawn, JE (2008) 30聽years after Alma-Ata: has primary health care worked in countries?. Lancet 372: pp. 950-961 nal" href="http://dx.doi.org/10.1016/S0140-6736(08)61405-1" target="_blank" title="It opens in new window">CrossRef
  4. ng class="a-plus-plus">World Economic Outlook Database.ng> Available at: [http://www.imf.org]; 2013 (accessed 13.08.25)
  China Statistical Yearbook (2012). National Bureau of Statistics of China, Beijing, CN
  5. Blumenthal, D, Hsiao, W (2005) Privatization and its discontents鈥搕he evolving Chinese health care system. N Engl J Med 353: pp. 1165-1170 nal" href="http://dx.doi.org/10.1056/NEJMhpr051133" target="_blank" title="It opens in new window">CrossRef
  6. Wang, H, Xu, T, Xu, J (2007) Factors contributing to high costs and inequality in China鈥檚 health care system. JAMA 298: pp. 1928-1930 nal" href="http://dx.doi.org/10.1001/jama.298.16.1928" target="_blank" title="It opens in new window">CrossRef
  7. Liu, Y, Hsiao, WC, Eggleston, K (1999) Equity in health and health care: the Chinese experience. Soc Sci Med 49: pp. 1349-1356 nal" href="http://dx.doi.org/10.1016/S0277-9536(99)00207-5" target="_blank" title="It opens in new window">CrossRef
  8. Macinko, J, Starfield, B, Shi, L (2003) The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970鈥?998. Health Serv Res 38: pp. 831-865 nal" href="http://dx.doi.org/10.1111/1475-6773.00149" target="_blank" title="It opens in new window">CrossRef
  9. Shi, L, Starfield, B, Politzer, R, Regan, J (2002) Primary care, self-rated health, and reductions in social disparities in health. Health Serv Res 37: pp. 529-550 nal" href="http://dx.doi.org/10.1111/1475-6773.t01-1-00036" target="_blank" title="It opens in new window">CrossRef
  10. Luo, Y, Li, J, Xu, CJ, Zhang, W, Xu, HQ, Sun, YH (2011) Analysis on health human resources in primary health care facilities in Anhui province: 2004鈥?010. Chin Rural Health Serv Admin 31: pp. 1237-1239
  11. Wang, F, Zhu, XX, Ding, X (2012) Analyzing the status of grassroots health human resources allocation in China and its equity. Chin Health Service Manage 29: pp. 108-110
  12. Health Department of Jiangsu: ng class="a-plus-plus">Operating Instructions for National Health Statistics and Reporting System.ng> Available at: [n/gb/jsswst/tjxx/xgzl/userobject1ai16821.html" class="a-plus-plus">http://www.jswst.gov.cn/gb/jsswst/tjxx/xgzl/userobject1ai16821.html]; 2007 (accessed 13.05.25) (in Chinese).
  13. Brown, MC (1994) Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on Alberta data. Soc Sci Med 38: pp. 1243-1256 nal" href="http://dx.doi.org/10.1016/0277-9536(94)90189-9" target="_blank" title="It opens in new window">CrossRef
  14. Theodorakis, PN, Mantzavinis, GD, Rrumbullaku, L, Lionis, C, Trell, E (2006) Measuring health inequalities in Albania: a focus on the distribution of general practitioners. Hum Resour Health 4: pp. 5 nal" href="http://dx.doi.org/10.1186/1478-4491-4-5" target="_blank" title="It opens in new window">CrossRef
  15. Liu, ZW (2003) Mesures of inequality distribution of income: a system review. Stat Inform Forum 18: pp. 28-32
  16. Borrell, LN, Talih, M (2011) A symmetrized Theil index measure of health disparities: an example using dental caries in U.S. children and adolescents. Stat Med 30: pp. 277-290 nal" href="http://dx.doi.org/10.1002/sim.4114" target="_blank" title="It opens in new window">CrossRef
  17. Hann, M, Gravelle, H (2004) The maldistribution of general practitioners in England and Wales: 1974鈥?003. Br J Gen Pract 54: pp. 894-898
  18. Araar A, Duclos J Y: ng class="a-plus-plus">DASP: Distributive Analysis Stata Package.ng> PEP, CIRPEE and World Bank, Universit茅 Laval, 2007
  19. Ahmad, KA, Najafi, B, Haghparast-Bidgoli, H (2011) Geographic distribution of need and access to health care in rural population: an ecological study in Iran. Int J Equity Health 10: pp. 39 nal" href="http://dx.doi.org/10.1186/1475-9276-10-39" target="_blank" title="It opens in new window">CrossRef
  20. Williams, RF, Doessel, DP (2006) Measuring inequality: tools and an illustration. Int J Equity Health 5: pp. 5 nal" href="http://dx.doi.org/10.1186/1475-9276-5-5" target="_blank" title="It opens in new window">CrossRef
  21. Ameryoun, A, Meskarpour-Amiri, M, Dezfuli-Nejad, ML, Khoddami-Vishteh, H, Tofighi, S (2011) The assessment of inequality on geographical distribution of non-cardiac intensive care beds in Iran. Iran J Public Health 40: pp. 25-33
  22. Central Committee of the Communist Party and State Council, People鈥檚 Republic of China: ng class="a-plus-plus">The Standing Conference of State Council of China Adopted Guidelines for Furthering the Reform of Health-Care System in Principle.ng> Available at: [news.xinhuanet.com/newscenter/2009-04/06/content_11138803_3.htm" class="a-plus-plus">http://news.Xinhuanet.com/newscenter/2009-04/06/content_11138803_3.htm]; 2009 (Accessed 13.07. 15) (in Chinese)
  23. Zhao, Y, Li, X, Zhang, YC, He, ZF, Song, YD, Zhang, WD, Cao, ZH (2010) Status and effect of two-way referral system in China: a system review. Chin General Pract 13: pp. 3500-3503
  24. Wang, HB, Wang, ZG, Shan, J, Li, CX, Zhang, SH, Zhang, XJ, Zhu, Z, Zhang, DY, Li, ZS (2010) Practice exploration of basic medical system in community. Chin Health Econ 29: pp. 26-28
  25. Isabel, C, Paula, V (2010) Geographic distribution of physicians in Portugal. Eur J Health Econ 11: pp. 383-393 nal" href="http://dx.doi.org/10.1007/s10198-009-0208-8" target="_blank" title="It opens in new window">CrossRef
  26. Toyabe, S (2009) Trend in geographic distribution of physicians in Japan. Int J Equity Health 8: pp. 5 nal" href="http://dx.doi.org/10.1186/1475-9276-8-5" target="_blank" title="It opens in new window">CrossRef
  27. Zhang, KJ, Li, SD, Hu, XL, Xu, T, Jin, AN, Zhou, M (2004) A survey and analysis on the huamn resources in community health services in Jiangsu province. Chin General Pract 7: pp. 1753-1754
  28. Yao, Y, Hou, WL, Lu, ZX, Li, YB, Li, XD, Jia, LG, Zhang, L (2010) The equity analysis of human resource allocation of community health services in the cities of Hubei province. Chin Health Econ 29: pp. 37-39
  29. Gong, XG, Hu, SL (2005) The equity of standards of health resource allocation within different provinces. Chin Health Econ 24: pp. 26-29
  30. Kiadaliri, AA, Hosseinpour, R, Haghparast-Bidgoli, H, Gerdtham, UG (2013) Pure and social disparities in distribution of dentists: a cross-sectional province-based study in Iran. Int J Environ Res Public Health 10: pp. 1882-1894 nal" href="http://dx.doi.org/10.3390/ijerph10051882" target="_blank" title="It opens in new window">CrossRef
  31. Li, CF, Liu, XH, Ke, SS, Tu, YQ, Lu, ZX (2013) Analysis on the fairness of the human resources of the primary health services in Wuhan city. J Pub Health Prev Med 24: pp. 45-47
  32. Lai, YW, Meng, QY, Wang, WH, Dawa, T, Li, SP (2013) Equity analysis of medical health resource allocation in three prefectures of Tibet. Chin Health Econ 32: pp. 63-64
  
• 刊物主题：Public Health; Development Economics; Quality of Life Research; Social Policy;
• 出版者：BioMed Central
• ISSN：1475-9276

文摘

Introduction Since the late 1990s, the Chinese government has carried out several reforms on the primary health care, which is greatly improved but still left much to be desired, especially for the health workforces. The aim of this study was to analyze the number of health workforces and the trends in distribution of health workforces in Jiangsu province of eastern China from 2008 to 2012. Methods The time trends in number and distribution of health professionals were compared in study period. Lorenz curves were plotted and Gini coefficient, Atkinson index and Theil index were calculated for inequalities in the distribution of health workforces to population and area. Results The number of health workforces increased every year and the inequality in the distribution of health workforces showed a decline trend from 2008 to 2012. After 2009, these trends changed more rapidly. There was the disproportionality between physicians and nurses. The values of three inequality indicators based on area were larger than those based on population. Conclusion The health reform in 2009 might play an important role in increasing the number of health workforces and improving the distribution of health workforces in primary health care facilities. The disproportionality between physicians and nurses was related to the shortage of number of nurses.