Equity in basic health human resource allocation in China before and after health reform

Objective To analyze the fairness of basic health human resource distribution in various cities and provinces in China before and after health reform.Methods Theil index and Gini coefficient were adopted to measure the disparity in health human resources allocation and analyze the changes of equity in health human resource distribution before and after health reform.Results The Gini coefficient for human resource of township health centers in China ranged from 0.304 0 to 0.509 0 between 2008 and 2013.During the 6-year period,the Gini coefficients for all aspects of human resource allocation declined except for the increased Gini coefficient for practicing physicians (0.444 2,0.453 1,and 0.461 5 in the year of 2008,2011,and 2013).Furthermore,the Theil index of practicing physicians allocation increased gradually during the period (0.352 1,0.366 5,and 0.375 8 in the year of 2008,2011,and 2013).The Theil index of nurses allocation fluctuated within the duration (0.474 8,0.491 7,and 0.467 4 in the year of t 2008,2011,and 2013).The contribution of within-regional Theil index is much greater than that of inter-regional Theil index.Conclusion The equity in health human resource allocation was generally improved after the health reform based on the assessment with Theil index and Gini coefficient.The rank for the equity in various aspects of resource allocation in descending order is health technicians per one thousand population,health technicians,on-the-job personnel,physicians,staff with education of college or above,practicing physicians,and nurses.