Inequality Assessment of Hospital Resources Distribution in West Azarbaijan Province Using Economic Indicators, Before-After Health System Reform plan

Equity in access to health care services is one of the
main goals of health systems, so that inequality in the geographical
distribution of health resources will make it difficult for individuals to
access the health care facilities. This study aimed to determine the
distribution status of hospital resources and inequality coefficient in
the West Azarbaijan province before and after implementation of the
health system reform plan.
Methods: This cross-sectional and descriptive-analytic study aimed to
investigate inequality in the distribution of health resources in cities of
West Azarbaijan province before and after health system reform plan
using concentration ratio and Hall Tiedman indices. The required data
for estimating these indices were the number of specialist physicians
and hospital beds, which were extracted from the data base of
treatment deputy in Urmia University of Medical Sciences. Data
analysis was conducted by Excel software.
Results: The results indicated a high spatial concentration in
distribution of the health resources in the province, so that fixed beds
and specialist physicians were more concentrated in the capital city of
province; Urmia. Moreover, inequality in distribution of the resources
in cities of the province was highly related to population.
Comparisons of the results before and after the health system reform
plan showed that the distribution of fixed beds and specialist
physicians had decreasing and increasing trends, respectively.
Conclusion: The results showed that inequality in distribution of the
hospital beds was intensified after implementation of the health
reform plan. Furthermore, distribution of specialist physicians after
the reform plan, despite its improvement, was not according to the
population distribution. Therefore, inappropriate distribution of the
above-mentioned resources should be readjusted by adopting
redistributive policies