Health Resource Allocation in Jiangxi Province Before and After the COVID-19 Pandemic (2015–2024): An Entropy-Weighted TOPSIS and Rank-Sum Ratio Assessment

Abstract Background The equitable allocation of health resources is a fundamental determinant of population health outcomes. To examine how a major public health emergency reshapes the regional distribution of health resources, this study evaluated health resource allocation in Jiangxi Province before and after the COVID-19 pandemic. Methods Per-1,000-population health resource data for 11 prefecture-level cities in Jiangxi Province from 2015 to 2024 were used. Entropy-weighted TOPSIS and the rank-sum ratio (RSR) method were applied for a comprehensive evaluation. The study period was divided into a pre-pandemic window (2015–2019) and a post-pandemic window (2020–2024) to compare resource allocation before and after the outbreak. Results Both methods indicated that the overall level of health resource allocation in Jiangxi improved markedly after the pandemic. Provincial per-1,000-population beds, practicing (assistant) physicians, registered nurses, and health-care expenditure rose by 38.6%, 40.9%, 44.9%, and 40.8%, respectively, while inter-city dispersion (coefficient of variation) was roughly halved. The entropy weight of health-care expenditure surged from 6.9% to 23.3% (a 16.4-percentage-point increase). Nanchang and Pingxiang consistently ranked in the top two in both periods; Fuzhou and Yichun improved markedly, whereas Yingtan and Ganzhou declined. Conclusions The COVID-19 pandemic accelerated the expansion and equalization of health resources in Jiangxi, with fiscal input emerging as a new principal dimension of disparity. Sustained, equity-oriented fiscal redistribution is needed to consolidate gains in less-developed regions.