Volume 21, Issue 3 (May - June 2022)
Payesh 2022, 21(3): 227-236 |
Back to browse issues page
Ethics code: IR.UOZ.REC.1400.011
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Mojiri A, َََAhmadi K. Inequality in the distribution of resources in health care system by using the Gini coefficient and Lorenz curve (A case study of Sistan and Baluchestan province over a five-year period). Payesh 2022; 21 (3) :227-236
URL: http://payeshjournal.ir/article-1-1874-en.html
URL: http://payeshjournal.ir/article-1-1874-en.html
1- Faculty of Science, University of Zabol, Sistan and Baluchestan, Iran
2- Faculty of Mathematical Sciences, Shahrekord University, Chaharmahal and Bakhtiari, Iran
2- Faculty of Mathematical Sciences, Shahrekord University, Chaharmahal and Bakhtiari, Iran
Abstract: (2132 Views)
Objective(s): One of the most important goals of health systems is to provide equal access to health care services and fair distribution of their indicators. The aim of this study was to evaluate the inequality in access to human resources, health care, and hygienic services in 14 cities of Sistan and Baluchestan province.
Methods: This was a descriptive study. Unequal access to health care services was assessed according to several items such as the number of physicians (general practitioner, pharmacist, and dentist), specialist physicians, paramedics, hospitals, active beds, laboratories, and pharmacies. The data was collected from the statistical yearbooks of the province. The Gini coefficient and Lorenz curve were the criteria to measure inequality. Data analysis and visualizations are performed in R software.
Results: Based on the five years studied (2014-2019), the number of physicians, specialist physicians, hospitals, and active beds per ten thousand persons in 2019 has increased compared to 2014. There was no significant increase in other measures. The mean Gini coefficient for physicians, specialists, paramedics, hospitals, active beds, laboratories, and pharmacies was 0.106, 0.324, 0.132, 0.317, 0.336, 0.12, and 0.299, respectively. The highest rate of unequal access was related to specialist physicians and active beds. Furthermore, the lowest rate was related to physicians and laboratories.
Conclusion: Gini coefficients for specialist physicians and active beds in 2019 compared to 2014 have decreased significantly over time. However, inequality in the distribution of these two health indicators was high. For other measures there were no significant decrease in the Gini coefficient. Thus, the finding suggests that the policy, by which the number of specialist physicians and physical resources of health (such as hospitals, active beds, and pharmacies) were increased, should be continued.
Methods: This was a descriptive study. Unequal access to health care services was assessed according to several items such as the number of physicians (general practitioner, pharmacist, and dentist), specialist physicians, paramedics, hospitals, active beds, laboratories, and pharmacies. The data was collected from the statistical yearbooks of the province. The Gini coefficient and Lorenz curve were the criteria to measure inequality. Data analysis and visualizations are performed in R software.
Results: Based on the five years studied (2014-2019), the number of physicians, specialist physicians, hospitals, and active beds per ten thousand persons in 2019 has increased compared to 2014. There was no significant increase in other measures. The mean Gini coefficient for physicians, specialists, paramedics, hospitals, active beds, laboratories, and pharmacies was 0.106, 0.324, 0.132, 0.317, 0.336, 0.12, and 0.299, respectively. The highest rate of unequal access was related to specialist physicians and active beds. Furthermore, the lowest rate was related to physicians and laboratories.
Conclusion: Gini coefficients for specialist physicians and active beds in 2019 compared to 2014 have decreased significantly over time. However, inequality in the distribution of these two health indicators was high. For other measures there were no significant decrease in the Gini coefficient. Thus, the finding suggests that the policy, by which the number of specialist physicians and physical resources of health (such as hospitals, active beds, and pharmacies) were increased, should be continued.
type of study: Descriptive |
Subject:
Sicial Medicine
Received: 2022/04/6 | Accepted: 2022/06/7 | ePublished ahead of print: 2022/06/14 | Published: 2022/07/19
Received: 2022/04/6 | Accepted: 2022/06/7 | ePublished ahead of print: 2022/06/14 | Published: 2022/07/19
References
1. Anjomshoa M Seyedin SH, Mousavi SM, Abasi M. Analysis of inequality in the distribution of health services in the cities of Yazd province. Akhlagh-e Zisti 2016; 3: 64-88 [In Persian]
2. Barati O, Keshtkaran A, Ahmadi B, Hatam N, Khammarnia M, Siavashi E. Equity in the health system: An overview on national development plans. Sadra Medical Sciences Journal 2015; 3: 77-88 [In Persian]
3. Kawachi I, Subramanian S, Almeida-Filho N. A glossary for health inequalities. Journal of Epidemiology and Community Health 2002; 56: 647-652 [DOI:10.1136/jech.56.9.647]
4. Kiadaliri AA, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to health care in rural population: an ecological study in Iran. International Journal for Equity in Health 2011; 10: 1-7 [DOI:10.1186/1475-9276-10-39]
5. Dejian L, Jin H, Jan M, Risser Asha S. Statistical properties of generalized Gini coefficient with application to health inequality measurement. Springer Science 2007; 87: 249-258 [DOI:10.1007/s11205-007-9170-y]
6. Omrani-Khoo H, Lotfi F, Safari H, Jame SZB, 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: 1299-1308
7. 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: 1653-1657 [DOI:10.19082/1653]
8. Karimzadeh M, Karimzadeh B. Evaluating development level of Sistan and Baluchistan province in termsof accessibility to health care services. Zanko Journal of Medical Sciences 2018; 19: 18-30 [In Persian]
9. Shahraki MR, Abbasi Hasanabadi N. Ranking the cities of Sistan and Baluchestan province based on health and treatment indices using the TOPSIS method. Journal of Payavard Salamat 2019; 12: 433-446 [In Persian]]
10. Zangane M, Omrani A, Shahabi M, Alikhani M, Gharlipour Z, Imanzad M. The nurse manpower distribution at state hospitals of Iran by Lorenz Curve and Gini index during 2001-2006. Journal of Ilam University of Medical Sciences 2013; 21: 174-181[In Persian]]
11. Nasiri A, Kiaei MZ, Yousefzadeh H, Kalhor R. Measuring inequality in the distribution of human health resources: A case study of Qazvin province. Nursing and Midwifery Journal 2021; 18: 766-773 [In Persian]
12. Rezaei S, Nouri, B. Evaluation of inequalities in the distribution of health resources by Gini coefficient and Lorenz curve: A case study in Kurdistan province from 2006 to 2013. Scientific Journal of Kurdistan University of Medical Sciences 2016; 20: 1-11 [In Persian]
13. Lorenz, MO. Method of measuring the concentration of wealth. Journal of the American Statistical Association 1905; 9: 209-219 [DOI:10.2307/2276207]
14. Wagstaff A, Paci P, van Doorslaer E. On the measurement of inequalities in health. Social Science and Medicine 1991; 33: 545-557 [DOI:10.1016/0277-9536(91)90212-U]
15. Mojiri A, Mohtashami GR, Waghei Y. Methods for parameter estimation of the Lorenz functional forms and compare them based on household expenses data. Journal of Statistical Research, Statistical Research and Training Center 2008; 5: 57-74 [In Persian] [DOI:10.18869/acadpub.jsri.5.1.57]
16. Brown MC. Using Gini-style indices to evaluate the spatial patterns of health practitioners: Theoretical considerations and an application based on Alberta data. Social Science and Medicine 1994; 38: 1243-1256 [DOI:10.1016/0277-9536(94)90189-9]
17. Kobayashi Y, Takaki H. Geographic distribution of physicians in Japan. Lancet 1992; 340: 1391-1393 [DOI:10.1016/0140-6736(92)92569-2]
18. Shahraki, M, Ghaderi, S. Inequality in distribution of physician and general practitioner in Sistan and Baluchestan province, Iran (2009-2017). Payesh 2020; 19: 177-186 [In Persian] [DOI:10.29252/payesh.19.2.177]
19. Mosadeghrad AM, Hashempour R, Veisy M. Equity in geographical distribution of medical specialists in Iran. Journal of Health Based Research 2017; 3: 25-37 [In Persian]
20. Nouraei Motlagh S, Darvishi B, Haghighatfard P, Lotfi F, Rezapoor A. Measuring equity in the distribution of physical and human resources in health sector among the cities of Lorestan province (2006-2014). Journal of Health Administration 2017; 20: 92-104 [In Persian]
21. Tahmasebi Ghorrabi A, Torabipour A, Zahiri M. The study of justice in the distribution of general and specialized physicians in Khuzestan province: 2018. Journal of Payavard Salamat 2020; 14: 108-120 [In Persian]
22. Lotfi F, Bayati M, Yusefi AR, Ghaderi S, Barati O. Inequality in distribution of health care resources in Iran: human resources, health centers and hospital beds. Shiraz E- Medical Journal 2018; 19: e63700 [DOI:10.5812/semj.63700]
23. Mokhtaripayam M, Bouzarjomehri H, Chivaee D, Shiva EH. Investigation of inequality trend in distribution of health sector resources in Iran during 2006, 2011 and 2016 timelines using Gini coefficient. Evidence Based Health Policy, Management and Economics 2019; 3: 191-201 [DOI:10.18502/jebhpme.v3i3.1510]
24. Barouni M, Moalemi S, Harati T, Jafari S. Distribution of pharmacies in Kerman province using Gini coefficient. Journal of Health Based Research 2015; 1: 25-35 [In Persian]
Send email to the article author
| Rights and Permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |