Distribution of health care resources in Mongolia using the Gini coefficient

Hum Resour Health. 2017 Aug 29;15(1):56. doi: 10.1186/s12960-017-0232-1.

Abstract

Background: Attaining the perfect balance of health care resources is probably impracticable; however, it is possible to achieve improvements in the distribution of these resources. In terms of the distribution of health resources, equal access to these resources would make health services available to all people. The aim of this study was to compare the distributions of health care resources in urban, suburban, and rural areas of Mongolia.

Methods: We compared urban and rural areas using the Mann-Whitney U test and further investigated the distribution equality of physicians, nurses, and hospital beds throughout Mongolia using the Gini coefficient-a common measure of distribution derived from the Lorenz curve. Two indicators were calculated: the distribution per 10 000 population and the distribution per 1000 km2 area.

Results: Urban and rural areas were significantly different only in the distribution of physicians per population. However, in terms of the distribution per area, there were statistical differences in physicians, nurses, and hospital beds. We also found that distributions per population unit were equal, with Gini coefficients for physicians, nurses, and hospital beds of 0.18, 0.07, and 0.06, respectively. Distributions per area unit were highly unequal, with Gini coefficients for physicians, nurses, and hospital beds of 0.74, 0.67, and 0.69, respectively.

Conclusions: Although the distributions of health care resources per population were adequate for the population size, a striking difference was found in terms of the distributions per geographical area. Because of the nomadic lifestyle of rural and remote populations in Mongolia, geographical imbalances need to be taken into consideration when formulating policy, rather than simply increasing the number of health care resources.

Keywords: Equality; Geographic distribution; Health resources; Mongolia; Physicians.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Health Services Accessibility / standards
  • Health Services Needs and Demand
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Mongolia
  • Primary Health Care / organization & administration*
  • Rural Health Services / statistics & numerical data*
  • Socioeconomic Factors
  • Urban Health Services / statistics & numerical data*