Volume 18, Issue 10 (January 2021)                   Nursing and Midwifery Journal 2021, 18(10): 766-773 | Back to browse issues page

XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

nasiri A, Kiai M Z, yosefzade H, kalhor R. MEASURING INEQUALITY IN THE DISTRIBUTION OF HUMAN HEALTH RESOURCES: A CASE STUDY OF QAZVIN PROVINCE. Nursing and Midwifery Journal 2021; 18 (10) :766-773
URL: http://unmf.umsu.ac.ir/article-1-4155-en.html
1- Master student, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran
2- Instructor, Faculty of Health, Qazvin University of Medical Sciences Qazvin, Iran
3- Associate Professor, Urmia University of Medical Sciences, Urmia, Iran
4- Associate professor, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran (Corresponding Author) , r.kalhor@gmail.com
Abstract:   (1714 Views)
Background & Aims: Achieving justice in the distribution of health services is one of the main goals of the health system. Therefore, the aim of this study was to determine equality in the distribution of health human resources (physicians) of Qazvin University of Medical Sciences before and after the health transformation plan based on Gini coefficient. Materials & Methods:  In the present descriptive-analytical and applied study, the statistical population was general practitioners, specialists, and subspecialists of Qazvin University of Medical Sciences during the years 2012 to 2018. Demographic statistics of the cities were extracted from the statistical yearbooks of the Statistics Center of Iran and physicians' statistics from the Vice-Chancellor for Treatment and Health of Qazvin University of Medical Sciences and inequality was measured using Gini coefficient and Lorenz curve in Excel 2016 and Stata 16 software. Results: According to the results, the highest number of general practitioners in 2015, specialists and subspecialists in 2018 and the lowest number were in 2017, 2012 and 2016, respectively. Also, the Gini coefficient of general practitioners in the years 2012 to 2018 was in the range of 0.61 and 0.63 and for specialist physicians, the lowest Gini coefficient was observed in 2016 (0.57) and the highest was found in 2018 (0.60) and it was 0.52 for subspecialists from 2012 to 2018. Conclusion: According to the Gini coefficient, inequality in the distribution of general practitioners in the province did not change after the health transformation plan, and among the specialist and subspecialty physicians, the Gini coefficient was in the range of inequality to high. The transformation plan was not successful in the equal distribution of manpower, so it is necessary to redistribute and implement distribution policies.  
Full-Text [PDF 611 kb]   (554 Downloads)    
Type of Study: Research | Subject: متفرقه

References
1. Horev T, Pesis-Katz I, Mukamel DB. Trends in geographic disparities in allocation of health care resources in the US. Health Policy (Amsterdam, Netherlands) 2004;68(2):223-32. [DOI:10.1016/j.healthpol.2003.09.011] [PMID]
2. Rashad H, Khadr Z. Measurement of health equity as a driver for impacting policies. Health Promot Int 2014; 29(1): i68-82. [DOI:10.1093/heapro/dau045] [PMID]
3. Omrani-Khoo H, Lotfi F, Safari H, Jame SZ, Moghri J, Shafii M. Equity in Distribution of Health Care Resources; Assessment of Need and Access, Using Three Practical Indicators. Iranian journal of public health 2013;42(11):1299-308. [PMCID]
4. Asl IM, Abolhallaje M, Raadabadi M, Nazari H, Nazari A, Salimi M, et al.Distribution of hospital beds in Tehran Province based on Gini coefficient and Lorenz curve from 2010 to 2012. Electron Physician 2015; 7(8): 1653-7. [DOI:10.19082/1653] [PMID] [PMCID]
5. Isabel C, Paula V. Geographic distribution of physicians in Portugal. Eur J Health Econ 2010; 11: 383-93. [DOI:10.1007/s10198-009-0208-8] [PMID]
6. Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo F, Huong N, et al. Human resources for health in southeast Asia: shortages, distributional challenges and international trade in health services. Lancet 2011;377:769-81. [DOI:10.1016/S0140-6736(10)62035-1] [PMID]
7. Ünal E. How the government intervention affects the distribution of physicians in Turkey between 1965 and 2000. Int J Equity Health 2015;;14(1):1-3. [DOI:10.1186/s12939-014-0131-1] [PMID] [PMCID]
8. Matsumoto K, Seto K, Fujita Sh, Kitazawa T, Hasegawa T. Population aging and physician maldistribution: A longitudinal study in Japan. Journal of Hospital Administration 2016; 5(1): 29-33. [DOI:10.5430/jha.v5n1p29]
9. Mostafavi H, Aghlmand S, Zandiyan H, Alipoori Sakha M, Bayati M, Mostafavi S. Inequitable Distribution Of Specialists And Hospital Beds In West Azerbaijan Province. Payavard 2015; 9 (1):55-66. [Google Scholar]
10. Brown M. Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on alberta data. Soc Sci Med 1994; 38: 1243-56. [DOI:10.1016/0277-9536(94)90189-9] [PMID]
11. Kobayashi Y, Takaki H. Geographic distribution of physicians in Japan. Lancet 1992;340: 1391-3. [DOI:10.1016/0140-6736(92)92569-2] [PMID]
12. Haghdost A, Kamyabi A, Asgar-Abad A, Sadeghi-Rad B. Geographical distribution of different groups of physician in Iran and survey, province inequality. jimc 2010; 28(4):411-9. (Persian) [URL]
13. 13 Horev T, Pesis-Katz I, Mukamel DB. Trends in geographic disparities in allocation of health care resources in the US. Health Policy 2004;68(2):223-32 [DOI:10.1016/j.healthpol.2003.09.011] [PMID]
14. Mostafavi H, Aghlmand S, Zandiyan H, Alipoori Sakha M, Bayati M, Mostafavi S. Inequitable distribution of specialists and hospital beds in west Azerbaijan province. Payavard Salamat 2015;9:55- 66. (Persian) [Google Scholar]
15. Ardelan A, Fatemi R, Alaedini F. The comprehensive study of the effective factors to estimate the required number of general physician in Iran. Proceedings of the Health Economic Congress Evaluation of Iran; 2002 Dec13; Tehran, Iran; 2002. (Persian).
16. Kunitz SJ. The recruitment, training, and distribution of physicians in Yugoslavia. Int J Health Serv 1980; 10(4):587-609. [DOI:10.2190/0Q25-HLXU-KGRE-2C5N] [PMID]
17. OECD (2001c) The DAC Journal: Development Cooperation: 2000 Report, OECD, Paris. [URL]
18. Amini N, Yadollahi H, Inanlo S. Health ranking in Iran's provinces. Social Welfare Quarterly 2007; 5(20): 40-8. (Persian). [URL]
19. Meliala A, Hort K, Trisnantoro L. Addressing the unequal geographic distribution of specialist doctors in Indonesia: the role of the private sector and effectiveness of current regulations. Soc Sci Med 2013;82:30-4. [DOI:10.1016/j.socscimed.2013.01.029] [PMID]
20. Masoud S, Tofighi S, Maleki M. Distributed to physician and nurse staffing in terms of population and its relationship with the number of beds in public hospitals in Iran. jhm 2010;31:7-14. Persian].
21. Matsumoto M, Koike S, Kashima S, Awai K. Geographic distribution of CT, MRI and PET devices in Japan: a longitudinal analysis based on national census data. PLoS ONE 2015; 10(5):e0126036 [DOI:10.1371/journal.pone.0126036] [PMID] [PMCID]
22. Iri H, Mahmoudi G, Jahani Tiji M A. The distribution of medical specialists in Golestan and Mazandaran Universities of Medical Sciences using Gini coefficient. Jorjani Biomed J 2017; 5(2):11-20. [Google Scholar]
23. Brown MC. Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on Alberta data. Soc Sci Med 1994;38(9):1243-56. [DOI:10.1016/0277-9536(94)90189-9] [PMID]
24. Khodadad Kashi F, Noraniazad S, Eshaghi Gorji M. The extent of competition, monopoly and behavioral pattern in iran's industries using nonstructural approach. Iranian Journal of Trade Studies 2017; 21:1-29 (Persian). [Google Scholar]
25. Ishikawa T, Nakao Y, Fujiwara K, Suzuki T, Tsuji S, Ogasawara K. Forecasting maldistribution of human resources for healthcare and patients in Japan: a utilization-based approach. BMC Health Serv Res 2019; 19:653. [DOI:10.1186/s12913-019-4470-x] [PMID] [PMCID]
26. Collection of instructions for the health system transformation program, executive version, version 1, Ministry of Health and Medical Education of the Islamic Republic of Iran, 2013 [URL]
27. Ameryoun A, Meskarpour-Amiri M, Lorgard Dezfuli-Nejad M, Khoddami-Vishteh HR, Tofighi Sh. The Assessment of Inequality on Geographical Distribution of Non-Cardiac Intensive Care Beds in Iran. Iran J Public Health 2011;40(2):25. [PMID] [PMCID]
28. Omrani-Khoo H, Lotfi F, Safari H, Jame SZ, Moghri J, Shafii M. Equity in Distribution of Health Care Resources; Assessment of Need and Access, Using Three Practical Indicators. Iran J Public Health 2013;42(11):1299. [PMID] [PMCID]
29. Kawachi I, Kennedy B, Lochner K, Prothrow-Stith D. Social capital, income inequality and mortality. Am J Public Health 1997;87(9):1491-8. [DOI:10.2105/AJPH.87.9.1491] [PMID] [PMCID]
30. Xie Y, Zhou X. Income inequality in today's China. Proc Natl Acad Sci U S A(PNAS) 2014; 111(19): 6928-33. [DOI:10.1073/pnas.1403158111] [PMID] [PMCID]
31. Shinjo D, Aramaki T. Geographic distribution of healthcare resources, healthcare service provision, and patient flow in Japan: a cross sectional study. Soc Sci Med 2012;75(11):1954-63. [DOI:10.1016/j.socscimed.2012.07.032] [PMID]
32. Nomura K, Inoue S, Yano E. The shortage of pediatrician workforce in rural areas of Japan. Tohoku J Exp Med 2009;217(4):299-305. [DOI:10.1620/tjem.217.299] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Nursing And Midwifery Journal

Designed & Developed by : Yektaweb