ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1586585
This article is part of the Research TopicIntegrating Economics into Population Health: Assessing Policies and OutcomesView all 10 articles
What Are the Key Factors Contributing to the Inequity in Healthcare Resource Allocation? -Evidence from China's Health Panel Data from 2009 to 2021
Provisionally accepted
- 1school of nursing and health management, Shanghai University of Medicine and Health Sciences, Shanghai, China
- 2Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China
- 3Kunming Medical University, Kunming, Yunnan Province, China
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Background: As economic growth drives higher demand for health services, equitable health resource allocation becomes crucial to meet diverse healthcare needs. Since China's reform and opening-up, increased government healthcare investment has not fully resolved regional disparities. Existing studies, often relying on methods other than the concentration index, fail to comprehensively analyze the link between resource inequities and economic factors. This study uses the concentration index and its decomposition to assess regional disparities and identify determinants of inequity, offering practical recommendations for optimizing resource distribution in China and similar developing nations.Methods: This study analyzed China's healthcare resource allocation (institutions, beds, and workforce) from 2009 to 2021 using the concentration index to measure equity across socio-economic regions and its decomposition method to identify contributing factors to inequality. Results: From 2009 to 2021, the numbers of institutions per 1000 people (IPK), beds per 1000 people (BPK), doctors per 1000 people (DPK), technicians per 1000 people (TPK), and nurses per 1000 people(NPK) in China increased. The concentration index (CI) for IPK remained negative, while BPK's CI turned negative after 2013. CIs for DPK, TPK, and NPK stayed positive. The CI for IPK's absolute value rose, while others decreased. Factors like population size (PS), population density(PD), geographical Location(GL), maternal mortality rate(MMR), rate of born-baby weighting less than 2.5kg (RBWL25), and perinatal mortality rate (PMR ) influenced unequal healthcare resource distribution, with PS and RBWL25 favoring developed areas, and PD, GL, and MMR favoring less developed regions. Additionally, urbanization level (UL), Out-of-Pocket (OPP), per capita health expenditures(PCHE), per capita gross domestic product(PCGDP), disposable income of urban residents(DIUR), government health expenditures (GHE), and number of insured( NI ) positively impacted resource allocation to developed provinces, with varying effects. Conclusions: This study analyzes 2009-2021 panel data, revealing growth trends and regional disparities in China's healthcare resource equity, focusing on institutions, beds, and workforce. Need variables (PS, PD, RBWL25) reduced bed/doctor disparities, while MMR/PMR worsened maternal/nurse inequities. Non-need economic factors concentrated resources in affluent areas despite redistribution efforts. The findings highlight ongoing challenges in equitable distribution and offer crucial policy insights for China and other developing nations.
Keywords: inequity, Health-care resources, Concentration index, determinants, China
Received: 03 Mar 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Dong, Wang, Ting, Chen, Gao and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Weimin Gao, Kunming Medical University, Kunming, 650500, Yunnan Province, China
Yuping Liu, Kunming Medical University, Kunming, 650500, Yunnan Province, China
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