Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan Province, China

BackgroundThere is a great disparity in spatial accessibility to hospital care between ethnic minority and non-minority regions in China. Being one of the basic social demands, spatial access to hospital care in minority regions draws increasing attention in China in recent years. We performed this study to have a better understanding of spatial access to hospital care in ethnic minority region in China, and to guide the allocation of government investment in the future.MethodsSichuan Province, southwest of China was selected as a sample to examine the difference in hospital access between ethnic minority and non-minority region in China. We applied the shortest path analysis and the enhanced two-step floating catchment area (E2SFCA) method under ArcGIS 9.3 environment.ResultsIn Sichuan, healthcare access in ethnic minority region is worse than in non-minority region in terms of time to hospital and the value of spatial accessibility. There is relatively greater inequality in access to doctors and health professionals than in access to hospital beds. In ethnic minority region, the balance between primary, secondary, and tertiary hospitals, as well as between public and private hospitals, is less even, compared with the non-minority region. The disparity within ethnic minority region is larger than in non-minority region.ConclusionsThe combination of shortest path analysis and E2SFCA method is superior to the traditional county ratio method in assessing spatial access to healthcare. Compared to the non-minority region, ethnic minority region rely more heavily on government investment to provide healthcare. In ethnic minority region, the current distribution of primary, secondary and tertiary hospitals is inappropriate, and there is an urgent shortage of healthcare personnel. We therefore recommend that the government use preferential policies to encourage more social capital investment in ethnic minority region, use government investment as a supplement to build a more equitable healthcare market, encourage doctors to work in such regions, and push forward road construction in rural area.

[1]  B. Gustafsson,et al.  Why Is There No Income Gap between the Hui Muslim Minority and the Han Majority in Rural Ningxia, China?* , 2014, The China Quarterly.

[2]  Dandan Zhang,et al.  A Comparison of Reform-Era Labor Force Participation Rates of China's Ethnic Minorities and Han Majority , 2005 .

[3]  Tijs Neutens,et al.  A commuter-based two-step floating catchment area method for measuring spatial accessibility of daycare centers. , 2015, Health & place.

[4]  Hui Liu,et al.  Assessing the spatial accessibility of hospital care in Sichuan Province, China. , 2015, Geospatial health.

[5]  N. Xu,et al.  The status of glycemic control: A cross-sectional study of outpatients with type 2 diabetes mellitus across primary, secondary, and tertiary hospitals in the Jiangsu province of China. , 2010, Clinical therapeutics.

[6]  Weifeng Li,et al.  A nighttime light imagery estimation of ethnic disparity in economic well-being in mainland China and Taiwan (2001–2013) , 2014 .

[7]  R. LaPorte,et al.  Childhood Diabetes in China: Enormous variation by place and ethnic group , 1998, Diabetes Care.

[8]  X. Zang Market Reforms and Han-Muslim Variation in Employment in the Chinese State Sector in a Chinese City , 2008 .

[9]  Q. She,et al.  Blood pressure control rate and associated risk factors in hospitals of different grades in Chongqing, China. , 2014, International journal of cardiology.

[10]  Matthew Richard McGrail,et al.  Measuring spatial accessibility to primary care in rural areas: Improving the effectiveness of the two-step floating catchment area method , 2009 .

[11]  Yi Qi,et al.  An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. , 2009, Health & place.

[12]  Huhua Cao,et al.  Urban–Rural Income Disparity and Urbanization: What Is the Role of Spatial Distribution of Ethnic Groups? A Case Study of Xinjiang Uyghur Autonomous Region in Western China , 2010 .

[13]  Tijs Neutens,et al.  Accessibility, equity and health care: review and research directions for transport geographers , 2015 .

[14]  Fahui Wang,et al.  Measures of Spatial Accessibility to Health Care in a GIS Environment: Synthesis and a Case Study in the Chicago Region , 2003, Environment and planning. B, Planning & design.

[15]  R. Smyth,et al.  Economic returns to speaking 'standard Mandarin' among migrants in China's urban labour market , 2011 .

[16]  Jiaping Wu The Rise of Ethnicity under China's Market Reforms , 2014 .

[17]  B. Sautman Scaling Back Minority Rights?: The Debate About China's Ethnic Policies , 2010 .

[18]  J. Donaldson,et al.  Tourism, Development and Poverty Reduction in Guizhou and Yunnan* , 2007, The China Quarterly.

[19]  Dandan Zhang,et al.  A Comparison and Decomposition of Reform-Era Labor Force Participation Rates of China's Ethnic Minorities and Han Majority , 2010, SSRN Electronic Journal.

[20]  B. Sautman Affirmative action, ethnic minorities and China's universities , 1997 .

[21]  Neng Wan,et al.  A relative spatial access assessment approach for analyzing potential spatial access to colorectal cancer services in Texas , 2012 .

[22]  J. Humphreys,et al.  The index of rural access: an innovative integrated approach for measuring primary care access , 2009, BMC health services research.