Research on the Equity and Optimal Allocation of Basic Medical Services in Guangzhou in the Context of COVID-19

Int J Environ Res Public Health. 2022 Nov 8;19(22):14656. doi: 10.3390/ijerph192214656.

Abstract

Optimizing the allocation of basic medical services and ensuring their equity are necessary to improve the ability to respond to public health emergencies and promote health equity in the context of COVID-19. This study aims to analyze the equity of Guangzhou's basic medical service and identify areas where health resources are relatively scarce. The spatial distribution and patterns of basic medical services were analyzed using kernel density analysis and standard deviation ellipse. The equity was analyzed using the Gini coefficient and Lorenz curve in terms of population and geographical area, respectively. Considering the medical demand and supply sides, the Gaussian two-step floating catchment area method was used to analyze the accessibility to different levels of medical institutions. The kernel density analysis and standard deviation ellipse showed that the spatial distribution of medical and health resources in Guangzhou is unevenly distributed, and high-level hospitals and medical resources are mainly concentrated in the centrum. From the perspective of population, Guangzhou's medical equity is generally reasonable. The accessibility of medical institutions differs with different levels, and the tertiary medical institutions have the best accessibility, while the unclassified, primary, and secondary medical institutions generally have lower accessibility. The accessibility of districts in Guangzhou varies greatly. Areas in the center are most accessible to basic medical services, while accessibility in outskirt areas has gradually decreased. Conclusion: The quantity of per capita medical and health resources in Guangzhou, as evidenced by basic medical services, is sufficient, but the spatial distribution is unequal. The developed city center enjoys more adequate healthcare resources than the distant suburbs. Primary healthcare should be built, especially in distant suburbs, to strengthen basic medical service equity in Guangzhou.

Keywords: G2SFCA; accessibility; basic medical services; equity; health care; resource allocation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Catchment Area, Health
  • Health Promotion
  • Health Resources
  • Health Services Accessibility*
  • Humans

Grants and funding

The authors are very grateful for the General Research Fund from National Natural Science Foundation of China (No. 42142025, No. 41630635, No. 41971184), National Natural Science Foundation of Guangdong Province (No. 2022A1515011113, No. 2018B030312004), Philosophy and Social Science Planning 2022 Spiritual Research Project of the 13th Provincial Party Congress of Guangdong Province (No. GD22TW06-09), Tertiary Education Scientific research project of Guangzhou Municipal Education Bureau (No. 202235023), and the 2022 Guangzhou Basic Research Program City School (College) Joint Funding Basic and Applied Basic Research Project.