Equity in health resource allocation in Guangdong Province, China, from 2013-2021: research based on the Dagum Gini coefficient and exploratory spatial data analysis.

backgroundThe equitable allocation of health resources is fundamental to achieving health equity. Guangdong Province, China’s largest province in terms of population and economic output, still faces marked inequities in the distribution of health resources across regions. This study aims to evaluate the equity of health resource allocation among Guangdong’s economic zones from 2013 to 2021, and to provide evidence to guide more fairness-oriented optimization of resource distribution and reduction of regional disparities.

methodsThis study utilized data from the Guangdong Health Statistical Yearbook (2013–2021). Nine indicators were selected across three dimensions: human, physical, and financial resources. The Dagum Gini coefficient was applied to assess inequalities in the distribution of health resources. In addition, the global Moran’s I and local indicators of spatial association (LISA) were computed to examine spatial autocorrelation and identify clustering patterns in health resources per thousand persons and per square kilometer.

resultsFrom 2013 to 2021, the total stock of health resources, per capita resources, and resources per square kilometer all increased. Nevertheless, per capita health resources in Guangdong remained below both the national average and levels observed in high-income countries, indicating persistent shortfalls in fair access. At the population level, the Dagum Gini coefficient declined for eight of the nine indicators, while at the geographic (area-based) level it decreased for six indicators, suggesting partial but uneven improvements in equity. Among all indicators, the Gini coefficient for general practitioners showed the greatest reduction, reflecting progress in primary-care–oriented redistribution. In 2021, the Dagum Gini coefficient for population-based health resource allocation fell below 0.25, whereas the coefficient for area-based allocation remained above 0.47, revealing pronounced place-based inequities. Tertiary hospitals, high-value medical equipment (above 10,000 yuan), and government financial subsidies exhibited the highest levels of inequality. Although global spatial autocorrelation levels were low, LISA analysis identified significant clustering, with low-high (LH) clusters predominantly located in the Pearl River Delta, indicating intra-regional unfairness in access to key resources.

conclusionWhile equity in health resource allocation has improved over time, substantial area-based inequities remain—particularly for tertiary hospitals, high-value equipment, and financial subsidies. To better meet the healthcare needs of Guangdong’s large population and advance health equity, continued efforts are required to expand health resources and, more importantly, to redistribute them more fairly. Policy interventions should therefore prioritize fairness by targeting structurally disadvantaged regions and mitigating intra–Pearl River Delta disparities through coordinated, equity-oriented regional healthcare development.