Fair distribution of physicians is a determining factor in health system policies. The present study aimed to investigate the equity in the distribution of general and specialist physicians in the affiliated cities of Ahvaz Jundishapur University of Medical Sciences. This descriptive cross-sectional study was performed in 2019. Population data were collected through the Statistics Center of Iran and The number of physicians was collected through the relevant departments of the university and the organizations of the medical and planning system of Khuzestan province in 2019. Then, using ratio indices, Gini coefficient, and Lorenz curve, the status of physicians distribution was investigated. Excel software was used to analyze the data.
Hendijan (0.5) and Haftkel (0.49) had the highest ratio of general practitioners to the population and Mahshahr port (0.11) had the lowest. The highest ratio of specialized physicians to the population was in Karun with 0.75 and the lowest ratio was in Bavi (0.04). The Gini coefficient of distribution of general practitioners, specialists, and all the physicians in the study population was 0.16, 0.31, and 0.19, respectively. The Lorenz curve showed the distribution of physicians and confirmed the Gini coefficients. The ratio of general practitioners and specialists to the population in the study population is low, but the distribution of general practitioners and all the physicians are fair and specialist physicians are unfair. Policymakers and university administrators should pay special attention to increasing the ratio of general practitioners and specialists to the population and the fair distribution of specialist physicians.
1. Mohammadbeigi A, Hassanzadeh J, Eshrati B, Mohammadsalehi N. Inequity in Health Measurement Indexes and Application to the Health Care Utilization Data. Iran J Epidemiol. 2013;9(2):1-14.
2. Nasiripour AA, Nael Befrooei E, Komeili A, Riahi L, Hajinabi K. Identification of Human Factors Affecting the Equitable Distribution of Health and Medical Facilities in the Social Security Organization. J Med Counc Iran. 2019;37(1):38-42.
3. Rezaee MR, Daei-Karimzadeh S, Fadaei M, Etbarian A, Bahrami H. Relationship of Provision Financial Resources, Physical and Legal Infrastructures, and Manpower in Implementing "Health Insurance of Villagers and Nomads Program" Developed by Iran Health Insurance Organization. Iran J Health Insur. 2019;2(1):21-9.
4. Mosadeghrad A, Janbabaei G, Kalantari B, Darrudi A, Dehnavi H. Equity in distribution of hospital beds in Iran. Sci J Kurdistan Univ Med Sci. 2020;24(6):12-36.
5. Ehsani Chimeh E, Ghadakchi A, Yazdi Feyzabadi V, Sadrossadat S, Mahi A, Mehrolhassani MH, et al. Investigating Availability and Distribution Trend of Human Resources Affiliated to the Ministry of Health and Medical Education in Iran from 2009 to 2015. Iran J Epidemiol. 2019;14:60-71.
6. Noori Hekmat S, Hashemi H, Haghdoost A, Haji Aghajani M, Janbabaee G, Maher A, et al. Specialized and Geographic Distribution of Specialists in Iran in 2016 and its Estimates in 2026. Iran J Epidemiol. 2018;13(5):122-32.
7. McLeod L. The association between physician supply and the mix of generalist and specialist services used. Contemp Econ Policy. 2015;33(3):434-49.
8. Bayat M, Shokri A, Mirbahaeddin E, Khalilnezhjad R, Khatibi SR, Fattahi H, et al. Geographic distribution of active medical specialists in Iran: A three-source capture-recapture analysis. Arch Iran Med. 2020;23(1):15-22. [Article in Persian].
9. Yazdi Feyzabadi V, Mehrolhassani M, Khosravi S. Study of Geographical Inequality Trend in Distribution of Human Resources and Health Facilities in Health Sector of Iran in Past Decade. Iran J Epidemiol. 2018;13:27-36.
10. Shafii M, Hashemi FS, Askari R, Pakdaman M, Bahariniya S. Estimation of the Required Staffing Capacity of Selected Hospitals in Yazd City, Iran, in Accordance with Staffing Standards of Iranian Ministry of Health and Medical Education in Year 2017. Health Inf Manage. 2019;16(2):57-64.
11. Dolea C, Stormont L, Braichet JM. Evaluated strategies to increase attraction and retention of health workers in remote and rural areas. Bull World Health Organ. 2010;88(5):379-85. doi:10.2471/BLT.09.070607
12. WHO. Working together for health. The world health report: 2006. Switzerland, Geneve. 2005:1-209.
13. Nikravan A, Ahmadi AM. Equality and equity in utilization of health services in Iran; indirect standardization approach. Hakim Res J. 2018;21(1):28-40.
14. Mosadeghrad AM, Hashempour R, Veisy M. Equity in geographical distribution of medical specialists in Iran. J Health Based Res. 2017;3(1):25-37. [Article in Persian].
15. Elarabi HM, Johari F. The impact of human resources management on healthcare quality. Asian J Manag Sci Educ. 2014;3(1):13-22.
16. Shinjo D, Aramaki T. Geographic distribution of healthcare resources, healthcare service provision, and patient flow in Japan: a cross sectional study. Soc Sci Med. 2012;75(11):1954-63.
17. Eygelaar JE, Stellenberg EL. Barriers to quality patient care in rural district hospitals. Curationis. 2012;35(1):36.
18. Oliveira APC, Gabriel M, Poz MR, Dussault G. Challenges for ensuring availability and accessibility toin health care services under Brazil’s Unified Health System (SUS). Cien Saude Colet. 2017;22(4):1165-80.
19. Fleurbaey M, Schokkaert E. Unfair inequalities in health and health care. J Health Econ. 2009;28(1):73-90.
20. Valadi Beyranvand A, Maher A, Jafari M. Assessment of Distribution of Nursing Staff in Hospitals affiliated to the Ministry of Health and Medical Education before and after the Implementation of the Health System Evolution Plan. J Health Promot Manag. 2019;8(2):16-22.
21. Sundmacher L, Ozegowski S. Regional distribution of physicians: The role of comprehensive private health insurance in Germany. Eur J Health Econ. 2016;17(4):443-51.
22. Nouraei MS, Darvishi B, Haghighatfard P, Lotfi F, Rezapoor A. Measuring equity in the distribution of physical and human resources in health sector among the cities of Lorestan Province (2006-2014). J Health Adm. 2017;20(69):92-104.
23. Karimi I. Health economic: Glossary and concepts definitions. Tehran: Social Security Research Institute; 2008. pp.240-4. [Book in Persian].
24. Brown M. Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on Alberta data. Soc Sci Med. 2004;38(9):1243-56.
25. Haghdoost AA, Kamyabi A, Ashrafi Asgarabad A, Sadeghi Rad B, Shafieian H, Ghasemi SH. Geographical distributions of different groups of medical staff in the country and provincial inequalities. Med Counc Iran. 2010;28(4):411-9. [Article in Persian].
26. Honarmand R, Yandarani M, Ansarifar A, Mansurian M, Niknam A. Inequality in distribution of general physicians in primary health care in Bushehr, Iran (2010-2013). Payesh. 2016;15(5):505-14. [Article in Persian].
27. Matsumoto M, Inoue K, Farmer J, Inada H, Kajii E. Geographic distribution of primary care physicians in Japan and Britain. Health Place. 2010;16(1):164-6.
28. Theodorakis PN, Mantzavinis GD, Rrumbullaku L, Lionis C, Trell E. Measuring health inequalities in Albania: A focus on the distribution of general practitioners. Hum Resour Health. 2006;4(1):5.
29. Yardım MS, Uner S. Geographical disparities in the distribution of physicians in Turkey. TAF Prev Med Bull. 2013;12(1):487-94.
30. Zandiyan H, Ghiasvand H, Nasimi Doset R. Measuring inequality of distribution of health resources: A case study. Payesh. 2011;11(6):799-805. [Article in Persian].
31. Goudarzi R, Meshkani Z, Barooni M, Jahanmehr N, Moalemi S. Distribution of general practitioners in the health system of Iran using equity indices (Gini, Atkinson). Health Dev J. 2015;4(3):247-58. [Article in Persian].
32. Hara K, Otsubo T, Kunisawa S, Imanaka Y. Examining sufficiency and equity in the geographic distribution of physicians in Japan: A longitudinal study. BMJ Open. 2017;7(3):e013922.
Copyright © 2024 Archives of Pharmacy Practice, All rights are reserved and for all open access contents, the Creative Commons licensing terms apply.
Developed by Archives of Pharmacy Practice
