Evaluation of equity and efficiency in health resource allocation in underdeveloped county areas: empirical research from Guangxi, China

BACKGROUND: This study aims to analyze the equity and efficiency of health resource allocation in underdeveloped county areas, providing a reference for improving health resource policies in such regions. METHODS: Focusing on eight underdeveloped counties in Guangxi, China, this research evaluates the fairness of health resource distribution using the Gini coefficient and Lorenz curve, and assesses allocation efficiency through the Data Envelopment Analysis model. RESULTS: In terms of equity in health resource allocation from 2015 to 2021, the Gini coefficients for health resources per capita were between 0.07 and 0.23, indicating the highest level of equity; the fairness in the distribution of healthcare human resources was lower than that of medical institutions and hospital beds, with particularly low equity observed in the distribution of licensed (assistant) physicians. Regarding efficiency, the overall efficiency of health resource allocation averaged between 0.899 and 0.933, with the number of counties achieving efficiency fluctuating between three and five. There were inefficiencies observed, particularly in technical and scale efficiency, with low scale efficiency being a significant factor affecting the efficiency of health resource allocation in underdeveloped counties. CONCLUSION: The distribution of health resources based on population and GDP demonstrates greater equity compared to distribution based on geographic areas. The equity of institutions and beds is superior to that of healthcare human resources. Overall, the efficiency of health resource allocation is not high, and there are regional disparities in efficiency. Recommendations include increasing the focus on health resource allocation in underdeveloped areas, optimizing the management of healthcare human resources, and coordinating planning to improve the precision and rationality of resource investment, thereby enhancing the efficiency of health resource utilization.