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Equity in the allocation of oncology bed resources in China: Longitudinal data from 2008 to 2022
1Department of Organization and Personnel, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women's and Children's Hospital, The Affiliated Women's and children's Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China.
Objective:
Cancer has emerged as one of the most significant public health challenges in the 21st century. With rapidly growing demand for oncology services, the allocation of oncology bed resources is closely associated with the accessibility and effectiveness of cancer diagnosis and treatment. This study presents a comprehensive assessment of equity in oncology bed allocation across Chinese hospitals, providing evidence to inform policy decisions for optimizing cancer care resource distribution.
Methods:
Data were extracted from the China Health Statistics Yearbook (2007-2023), and analyzed using Lorenz curves, Gini coefficients(G), and Theil index (T) to evaluate the equity of oncology bed resource allocation in China.
Results:
From 2008 to 2022, the number of oncology beds in Chinese hospitals showed an increasing trend, but the growth rate slowed down. According to Lorenz curves, the equity of oncology bed allocation by population was better than by geographic area. Compared to 2008, the population-based equity improved in 2022, while the geographic area-based equity showed no improvement. Based on G, the population-based allocation of oncology beds from 2008 to 2022 had G between 0.15 and 0.20, indicating absolute equity with an overall declining trend, while the geographic area-based allocation maintained G around 0.69, consistently showing severe inequity. According to T, population-based allocation demonstrated better equity with T all below 0.1, whereas geographic area-based allocation showed poorer equity with indices all above 0.6. For both population and geographic dimensions, within-group T were greater than between-group indices, indicating that inequity primarily stemmed from intra-regional disparities.
Conclusion:
While China's oncology bed resources are expanding in scale, they are facing dual challenges of imbalanced "population-geography" allocation and significant regional differences. We should focus on improving geographical accessibility and regional balance to help alleviate the 'difficulty in hospitalization' for cancer patients.
