Inequality trends of health workforce in different stages of medical system reform (1985-2011) in China

Article English OPEN
Zhou, Kaiyuan ; Zhang, Xinyi ; Ding, Yi ; Wang, Duolao ; Lu, Zhou ; Yu, Min (2015)
  • Publisher: Springer Nature
  • Journal: Human Resources for Health, volume 13 (eissn: 1478-4491)
  • Related identifiers: doi: 10.1186/s12960-015-0089-0, pmc: PMC4673776
  • Subject: wa_525 | Inequality | Public Administration | d67ea616 | Medical system reform | Research | Health workforce | wa_540 | Public Health, Environmental and Occupational Health

Introduction\ud The aim of this study was to identify whether policies in different stages of medical system reform had been effective in decreasing inequalities and increasing the density of health workers in rural areas in China between 1985 and 2011.\ud \ud \ud Methods\ud With data from China Health Statistics Yearbooks from 2004 to 2012, we measured the Gini coefficient and the Theil L index across the urban and rural areas from 1985 to 2011 to investigate changes in inequalities in the distributions of health workers, doctors, and nurses by states, regions, and urban-rural stratum and account for the sources of inequalities.\ud \ud \ud Results\ud We found that the overall inequalities in the distribution of health workers decreased to the lowest in 2000, then increased gently until 2011. Nurses were the most unequally distributed between urban-rural districts among health workers. Most of the overall inequalities in the distribution of health workers across regions were due to inequalities within the rural-urban stratum.\ud \ud \ud Discussions and conclusions\ud Different policies and interventions in different stages would result in important changes in inequality in the distribution of the health workforce. It was also influenced by other system reforms, like the urbanization, education, and employment reforms in China. The results are useful for the Chinese government to decide how to narrow the gap of the health workforce and meet its citizens’ health needs to the maximum extent.
  • References (47)
    47 references, page 1 of 5

    1. WHO. The World Health Report 2006. Geneva: World Health Organization; 2006.

    2. Narasimhan V, Brown H, Pablos-Mendez A, Adams O, Dussault G, Elzinga G, et al. Responding to the global human resources crisis. Lancet. 2004;363: 1469-72.

    3. Zhang D, Unschuld PU. China's barefoot doctor: past, present, and future. The Lancet. 2008;372:1865-7.

    4. WHO. The World Health Report 2000-health systems: improving performance. Geneva: World Health Organization; 2001.

    5. Chen Z. Launch of the health-care reform plan in China. Lancet. 2009;373: 1322-4.

    6. Zou D, Ouyang R. Blue book of development and reform: report on Chinese economic development and institutional reform-China:30 years of reform and opening-up(1978-2008). Beijing: Social Sciences Academic Press; 2008.

    7. Hsiao WC, Liu Y. Economic reform and health-lessons from China. N Engl J Med. 1996;335:430-2.

    8. Bhattacharyya O, Delu Y, Wong ST, Bowen C. Evolution of primary care in China 1997-2009. Health Policy. 2011;100:174-80.

    9. Ministry of Personnel of P. R. of CHINA. Interim measures of state unassigning jobs for college graduates. 1996-01-09.

    10. Wang L, Liu J, Chin DP. Progress in tuberculosis control and the evolving public-health system in China. Lancet. 2007;369:691-6.

  • Metrics
    No metrics available
Share - Bookmark