Spatial equity and factors associated with intensive care unit bed allocation in China

Area of Science:

• Health Services Research
• Medical Resource Allocation
• Public Health Policy

Background:

• Unequal medical resource distribution is a significant challenge in healthcare management.
• Equitable intensive care unit (ICU) bed allocation is vital for timely access to critical care.
• This study addresses ICU bed allocation equity in China.

Purpose of the Study:

• To analyze the equity of ICU bed allocation across 31 provincial regions in China.
• To identify factors influencing ICU bed density and distribution.
• To provide a basis for improving ICU bed allocation strategies.

Main Methods:

• Analysis of ICU bed allocation equity using Gini coefficients and Lorenz curves (2021).
• Spatial analysis of ICU bed density using Global and Local Moran's indices.
• Grey correlation models to determine key influencing factors on ICU bed density.

Main Results:

• ICU bed allocation is highly inequitable by service area (Gini=0.68) but more balanced by population (Gini=0.14).
• ICU bed distribution by service area shows significant spatial clustering (Global Moran's I=0.22).
• Bed utilization rate strongly correlates with population-based ICU bed density; registered nurses per area strongly correlate with service area-based density.

Conclusions:

• ICU bed allocation by population is more equitable than by service area in China.
• Significant regional disparities in ICU bed allocation necessitate improved strategies.
• Future health planning should consider service area, bed utilization, and nursing staff for equitable ICU bed supply.