Is the health workforce distribution in Beijing, China perfectly equitable?

Abstract

Background: The quantity and distribution of the health workforce is one of the most important aspects of a health care system. Inequality in the distribution of the health workforce is common in China and in many developing countries. This paper aimed to evaluate and discuss inequality in the distribution of the health workforce in Beijing, China, and explain the sources of the inequality.
Methods: The study described and measured inequality in the distribution of the health workforce in Beijing using data from the Beijing Regional Statistical Yearbook 2017. The 16 districts of Beijing are divided into four divisions and the paper used methods from the economics literature, including the Lorenz curve, Gini coefficient and Theil L index, to measure inequality in the distribution of the health workforce at sub-provincial level in Beijing for three categories of health workers: doctors, nurses and all health workers.
Results: There are inequalities in the densities of health workers at the district and division levels. In terms of the densities of all health workers, doctors and nurses, the Capital Core Functional Division is 3.95 times, 3.82 times and 4.13 times, respectively, higher than the Urban Development New Division. All the Gini coefficients are between than 0.2 to 0.3, which means that the health worker distribution is rather equitable. The Theil L index shows that the inequalities mainly come from the differences between the four divisions, and that nurses are more unequally distributed between divisions (0.28 for Gini coefficient and 0.380 for the Theil L index).
Conclusions and recommendations: According to the study findings, the inequalities in health workforce distribution in Beijing could be addressed by increasing investment in the numbers and quality of nurses, as well as by establishing additional policies to attract more health workers to work in remote areas. Chinese governments need to think more carefully about the current distribution of health workers at the sub-provincial level. [Ethiop.J. Health Dev. 2019; 33(1):22-27]
Key words: Health workforce distribution, equality, Beijing, health resources