ArticleBMJ open2020
Differences in regional distribution and inequality in health-resource allocation at hospital and primary health centre levels: a longitudinal study in Shanghai, China.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
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55 citing papers in PubMed, 87 citations in OpenAlex.
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- Equity in health resource allocation in Guangdong Province, China, from 2013-2021: research based on the Dagum Gini coefficient and exploratory spatial data analysis.Cost effectiveness and resource allocation : C/E · 2026Article
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- Spatial-temporal characteristics and driving factors of the coupling coordination between primary health care and socioeconomic development: a case study of Beijing, China.BMC public health · 2025Article
- Assessing the spatiotemporal heterogeneity of resource allocation effects on patient flow in shanxi's County hospitals, China.Scientific reports · 2025Article
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- A scoping review of national policies for hierarchical medical system in China since the 2009 health reform.Frontiers in public health · 2025Article
- Health inequalities under decentralized governance: challenges in resource allocation and funding in Greece.Frontiers in health services · 2025Article
- Global burden of Hodgkin lymphoma among children and adolescents: a population-based study using GBD 2021.Frontiers in pediatrics · 2025Article
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Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo analyse differences in regional distribution and inequality in health-resource allocation at the hospital and primary health centre (PHC) levels in Shanghai over 7 years.
designA longitudinal survey using 2010-2016 data, which were collected for analysis.
settingThe study was conducted at the hospital and PHC levels in Shanghai, China. OUTCOME MEASURES: Ten health-resource indicators were used to measure health-resource distribution at the hospital and PHC levels. In addition, the Theil Index was calculated to measure inequality in health-resource allocation.
resultsAll quantities of healthcare resources per 1000 people in hospitals and PHCs increased across Shanghai districts from 2010 to 2016. Relative to suburban districts, the central districts had higher ratios, both in terms of doctors and equipment, and had faster growth in the doctor indicator and slower growth in the equipment indicator in hospitals and PHCs. The Theil Indices of all health-resource allocation in hospitals had higher values compared with those in PHCs every year from 2010 to 2016; furthermore, the Theil Indices of the indicators, except for technicians and doctors in hospitals, all exhibited downward time trends in hospitals and PHCs.
conclusionsIncreased healthcare resources and reduced inequality of health-resource allocation in Shanghai during the 7 years indicated that measures taken by the Shanghai government to deepen the new round of healthcare reform in China since 2009 had been successful. Meanwhile there still existed regional difference between urban and rural areas and inequality across different medical institutions. To solve these problems, we prescribe increased wages, improved working conditions, and more open access to career development for doctors and nurses; reduced investments in redundant equipment in hospitals; and other incentives for balancing the health workforce between hospitals and PHCs.
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