Equity and efficiency of public health resource allocation in China

OBJECTIVE: To analyze the equity and efficiency of public health resource allocation in China from 2018 to 2022, and to provide a scientific basis for promoting the development of public health resources in China. METHODS: Data on public health resources of 31 provincial-level administrative regions in mainland China were extracted from 2018 to 2022, and descriptive analysis, Theil index, and health resource agglomeration degree (HRAD) were used to analyze the equity, and data envelopment analysis (DEA) was used to analyze the efficiency. RESULTS: The Theil index of public health resource allocation by population in China ranges from 0.006 to 0.049, and the Theil index contribution rate of the number of beds, health technicians, licensed (assistant) physicians, and registered nurses within region is less than 28.76%. The Theil index of public health resource allocation by geography in China ranges from 0.274 to 0.624, and the Theil index contribution rate of the number of institutions, the number of beds, health technicians, licensed (assistant) physicians, and registered nurses within region is more than 77.05%. The HRAD of public health resources is more than 2.18 in the eastern and central regions, while the HRAD of public health resources is less than 1 in the northeastern and western regions. The overall HRAD/population agglomeration degree (PAD) is less than 1 in the northeastern and eastern regions, and greater than 1 in the central and western regions overall. The scale efficiency and overall efficiency of public health resource allocation in China are not 1, the returns to scale are decreasing, and the DEA is relatively ineffective from 2019 to 2022. CONCLUSION: The equity by geography is slightly worse than the equity by population, and the inequity by population mainly comes from between regions, while the inequity by geography mainly comes from within regions. There is a contradiction in the equity by population and by geography allocation in the eastern and western regions, and a congruence in the equity by population and by geography allocation in the northeastern and central regions. The DEA of public health resource allocation in China is relatively ineffective in 2019-2022.