IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i16p2813-d255445.html
   My bibliography  Save this article

Examining the Multi-Scalar Unevenness of High-Quality Healthcare Resources Distribution in China

Author

Listed:
  • Meng Yu

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

  • Shenjing He

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

  • Dunxu Wu

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

  • Hengpeng Zhu

    (Public Policy Research Center, Chinese Academy of Social Sciences, Beijing 100732, China)

  • Chris Webster

    (Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong, China
    Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China)

Abstract

Healthcare disparity is, to a large extent, ascribable to the uneven distribution of high-quality healthcare resources, which remains insufficiently examined, largely due to data unavailability. To overcome this barrier, we synthesized multiple sources of data, employed integrated methods and made a comprehensive analysis of government administrative structures and the socio-economic environment to build probably the most inclusive dataset of Chinese 3-A hospitals thus far. Calibrated on a sample of 379 hospitals rated by a reputable organization, we developed a realistic and viable evaluation framework for assessing hospital quality in China. We then calculated performance scores for 1246 3-A hospitals, which were aggregated and further analyzed at multiple scales (cities, provinces, regions, and economic zones) using general entropy indexes. This research shows that the fragmented governance and incoordination of “ kuai ” and “ tiao ” is rooted deeply in China’s legacy of centrally-planned systems, and has had a far-reaching yet partially contradictory influence over the contemporary distribution and performance of healthcare resources. Additionally, the unevenness in the distribution of healthcare resources is related closely to a city’s administrative rank and power. This study thus suggests that the policy design of healthcare systems should be coordinated with external socio-economic transformation in a sustainable manner.

Suggested Citation

  • Meng Yu & Shenjing He & Dunxu Wu & Hengpeng Zhu & Chris Webster, 2019. "Examining the Multi-Scalar Unevenness of High-Quality Healthcare Resources Distribution in China," IJERPH, MDPI, vol. 16(16), pages 1-20, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2813-:d:255445
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/16/2813/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/16/2813/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Kanbur, Ravi, 2000. "Income distribution and development," Handbook of Income Distribution, in: A.B. Atkinson & F. Bourguignon (ed.), Handbook of Income Distribution, edition 1, volume 1, chapter 13, pages 791-841, Elsevier.
    2. Stephen P. Jenkins, 2006. "Estimation and interpretation of measures of inequality, poverty, and social welfare using Stata," North American Stata Users' Group Meetings 2006 16, Stata Users Group, revised 06 Dec 2008.
    3. Zhang, Xiaobo & Kanbur, Ravi, 2005. "Spatial inequality in education and health care in China," China Economic Review, Elsevier, vol. 16(2), pages 189-204.
    4. Eriksson, Tor & Pan, Jay & Qin, Xuezheng, 2014. "The intergenerational inequality of health in China," China Economic Review, Elsevier, vol. 31(C), pages 392-409.
    5. Cowell, Frank A. & Kuga, Kiyoshi, 1981. "Additivity and the entropy concept: An axiomatic approach to inequality measurement," Journal of Economic Theory, Elsevier, vol. 25(1), pages 131-143, August.
    6. Martin Biewen & Stephen P. Jenkins, 2006. "Variance Estimation for Generalized Entropy and Atkinson Inequality Indices: the Complex Survey Data Case," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 68(3), pages 371-383, June.
    7. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    8. Pauline W Jansen & Fiona K Mensah & Jan M Nicholson & Melissa Wake, 2013. "Family and Neighbourhood Socioeconomic Inequalities in Childhood Trajectories of BMI and Overweight: Longitudinal Study of Australian Children," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
    9. Jonathan Haughton & Shahidur R. Khandker, 2009. "Handbook on Poverty and Inequality," World Bank Publications - Books, The World Bank Group, number 11985, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Fang Guo & Wei Wei & Bowen Xiang & Mengyao Hong, 2024. "Analysis of Regional Medical Supply and Demand Network Characteristics Based on “Patient Flow Phenomenon”: A Case Study of the Core Area of the Wuhan Metropolitan Area," Land, MDPI, vol. 13(2), pages 1-22, January.
    2. Xiaoguang Fan & Fei Yan & Wei Yan, 2020. "Better Choice, Better Health? Social Integration and Health Inequality among International Migrants in Hangzhou, China," IJERPH, MDPI, vol. 17(13), pages 1-13, July.
    3. Wanchun Xu & Zijing Pan & Shan Lu & Liang Zhang, 2020. "Regional Heterogeneity of Application and Effect of Telemedicine in the Primary Care Centres in Rural China," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    4. Xiang Yan & Shenjing He & Dong Dong, 2020. "Determining How Far an Adult Rare Disease Patient Needs to Travel for a Definitive Diagnosis: A Cross-Sectional Examination of the 2018 National Rare Disease Survey in China," IJERPH, MDPI, vol. 17(5), pages 1-18, March.
    5. Shangguang Yang & Danyang Wang & Chen Li & Chunlan Wang & Mark Wang, 2021. "Medical Treatment Behaviour of the Elderly Population in Shanghai: Group Features and Influencing Factor Analysis," IJERPH, MDPI, vol. 18(8), pages 1-21, April.
    6. Wenbin Wang & Yang Cao, 2022. "Network Diversity and Health Change among International Migrants in China: Evidence from Foreigners in Changchun," IJERPH, MDPI, vol. 19(23), pages 1-16, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dongjin Chen & Youxing Lang, 2021. "The cream‐skimming effect in China's health care services: A mixed methods study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(1), pages 113-133, January.
    2. Stephen P. Jenkins & John Micklewright, 2007. "New Directions in the Analysis of Inequality and Poverty," Discussion Papers of DIW Berlin 700, DIW Berlin, German Institute for Economic Research.
    3. Chris Elbers & Peter Lanjouw & Johan Mistiaen & Berk Özler, 2008. "Reinterpreting between-group inequality," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 6(3), pages 231-245, September.
    4. Nuno Crespo & Sandrina Berthault Moreira & Nádia Simões, 2011. "An integrated approach for the measurement of inequality, poverty, and richness," Working Papers 205, ECINEQ, Society for the Study of Economic Inequality.
    5. Chen, Xi & Yan, Binjian & Gill, Thomas M., 2020. "Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the United States," IZA Discussion Papers 13460, Institute of Labor Economics (IZA).
    6. Arief Anshory Yusuf & Andy Sumner & Irlan Adiyatma Rum, 2014. "Twenty Years of Expenditure Inequality in Indonesia, 1993-2013," Bulletin of Indonesian Economic Studies, Taylor & Francis Journals, vol. 50(2), pages 243-254, August.
    7. Mitsuhiro Hayashi & Mitsuhiko Kataoka & Takahiro Akita, 2012. "Spatial Dimensions of Expenditure Inequality and the Role of Education in Indonesia: An Analysis of the 2008-2010 Susenas Panel," Working Papers EMS_2012_21, Research Institute, International University of Japan.
    8. Pan, Jay & Liu, Gordon G. & Gao, Chen, 2013. "How does separating government regulatory and operational control of public hospitals matter to healthcare supply?," China Economic Review, Elsevier, vol. 27(C), pages 1-14.
    9. Xi Chen & Binjian Yan & Thomas M. Gill, 2022. "Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the USA," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 689-716, April.
    10. Pierre‐Richard Agénor, 2004. "Macroeconomic Adjustment and the Poor: Analytical Issues and Cross‐Country Evidence," Journal of Economic Surveys, Wiley Blackwell, vol. 18(3), pages 351-408, July.
    11. Kaika, Dimitra & Zervas, Efthimios, 2013. "The environmental Kuznets curve (EKC) theory. Part B: Critical issues," Energy Policy, Elsevier, vol. 62(C), pages 1403-1411.
    12. E. Jessica Hrudey & Anton E. Kunst & Karien Stronks & Tanja G.M. Vrijkotte, 2015. "Do Neighborhood Characteristics in Amsterdam Influence Adiposity at Preschool Age?," IJERPH, MDPI, vol. 12(5), pages 1-20, May.
    13. Joshua Aizenman & Yothin Jinjarak, 2012. "Income Inequality, Tax Base and Sovereign Spreads," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 68(4), pages 431-444, December.
    14. Sakaue, Katsuki, 2018. "Informal fee charge and school choice under a free primary education policy: Panel data evidence from rural Uganda," International Journal of Educational Development, Elsevier, vol. 62(C), pages 112-127.
    15. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    16. Casilda Lasso de la Vega & Ana Urrutia & Oscar Volij, 2011. "An Axiomatic Characterization Of The Theil Inequality Order," Working Papers 1103, Ben-Gurion University of the Negev, Department of Economics.
    17. Seungwoo Han, 2022. "Spatial stratification and socio-spatial inequalities: the case of Seoul and Busan in South Korea," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-14, December.
    18. Liu, Ye, 2015. "Geographical stratification and the role of the state in access to higher education in contemporary China," International Journal of Educational Development, Elsevier, vol. 44(C), pages 108-117.
    19. Abre-Rehmat Qurat-ul-Ann & Faisal Mehmood Mirza, 2021. "Multidimensional Energy Poverty in Pakistan: Empirical Evidence from Household Level Micro Data," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(1), pages 211-258, May.
    20. Bourguignon, Francois, 2005. "The Effect of Economic Growth on Social Structures," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 1, chapter 27, pages 1701-1747, Elsevier.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2813-:d:255445. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.