Research On Hospital Health Resources Allocation In Different Regions Of China

Background Optimizing health resources allocation is the basis for sustainable development of health service,the solution of “Medical Treatment Difficult and Expensive”.As the main part of health service delivery system,hospitals gather optimal health resources.According to the requirement of new health reform,hospital health resources allocation should reflect the principles of moderate scale and reasonable layout.Therefore it is necessary to research that whether the current hospital health resource allocation levels promote equity and meet the demand for health services.Objectives To understand the equity and the rationality of hospital health resources,the concept of agglomeration degree is introduced into health resource allocation evaluation in the paper,a new evaluation taking the demographic and geographical factor is established,which is used for the empirical research of quantity and scale disposition of hospitals in various regions of China.Meanwhile,combining the demand health service need,the status of hospital resources allocation is comprehensively evaluated,based on which we can put forward evidence-based suggestions for the reasonable deployment of hospital health resources.Content1.Methodological study on health resources allocation equity based on the concept of agglomeration degree.To establish a new evaluation method taking the difference in the areas of demographic and geographical distribution into consideration,and which is suitable to evaluate health resource allocation in the large regional scale,such as province-level administration or autonomous region.2.Empirical research on agglomeration degree evaluation of hospital health resources in China.Firstly,the agglomeration degree of public hospital and agglomeration degree of public hospital beds were compared between the regions with different population density.Secondly,the development status of non-public hospital in various regions was evaluated based on agglomeration degree.At last,agglomeration degree of China’s hospital health resources compared with that of Germany’s hospital health resources3.The empirical research results of agglomeration degree evaluation of hospital health resources,combined with the results of principal component analysis of health services demand,were used for evaluation on equity of hospital health。Main Results1.Health Resources Agglomeration Degree mean that the proportion of district’s health resources in 1% of national land,which reflect a district with a relatively higher resources agglomeration degree.When HRAD=1,the geography distribution in medical resource is absolutely fair.When HRAD-PAD=0,the population distribution in medical resource is absolutely fair.2.Public hospital agglomeration degree and beds agglomeration degree are more than 1mostly,but that of the sparsely-populated area is less than 1.In the densely-populated areas,compared with population agglomeration degree,hospital agglomeration degree is lower,and beds agglomeration degree is greater obviously.Besides,the agglomeration level difference between secondary hospitals and tertiary hospitals is widely existed in most regions of China.3.Except for a few areas,there are most other regions that the agglomeration degree and scale of non-public hospitals is far lower than that of public hospitals.And there are more comprehensive hospitals in non-public hospitals in China,and specialized hospitals gather greater in developed areas.4.Hospital agglomeration degree and beds agglomeration degree in Germany are close to that of population.But in the most districts of China,beds agglomeration is higher obviously than that of population and hospital.5.In the densely-populated areas,demand of health service is in high level(comprehensive scores obtained by principal component method,E>0),the hospital agglomeration degree lower(HARD-PAD<-0.5),the beds agglomeration degree higher,(HARD-PAD>0.5),beds agglomeration is higher obviously than that of hospital.In other areas of China,demand of basic health service is in high level(-1≤E<0),the hospital health resource agglomeration degree is moderate(-0.5<HARD-PAD<0.5),the hospital scale isn’t over-extended.Conclusions1.Irrationality of the regional public hospital resource allocation embodied in the poor geographical accessibility in the sparsely-populated area,the over-extended scale in the densely-populated areas and the unbalanced hospital-grade structure.2.The construction of medical organization with various forms is unformed in China.The development space of non-public hospital is squeezed by public hospital.Relative to EAD,the non-public hospital increases apparent lag.To avoid open battles with public hospital,social capital tends to establish specialized hospitals in the economically developed areas.3.Based on empirical research of Germany,the overall effect of regional health planning in China isn’t remarkable,and regional health planning have had little legal force,which contributes to Irrationality of the regional public hospital resource allocation.4.At present,in some districts which are affordable and healthy supply for basic health service is greater than the demand,in some districts which are unaffordable and in poor health supply for basic health service is less than the demand.The uneven distribution and different accessibility of health resources in various regions became a constraint to improve the general level of health,finally caused the inequity of health.Recommendations1.Implementation of health resource optimization allocation strategy according to law2.Define the scope for basic health service,strengthen functional management of Public Hospital3.The development of non-public hospitals should be encouraged,so that it is urgent for the construction of medical organization with various forms.4.The allocation of hospital health resources is modified based on the population agglomeration degree and the level of demand in health service.