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

Background:  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.