Equity in the Allocation of General Practitioner Resources in Mainland China from 2012 to 2019

Background: General practitioners (GPs) play a vital role in primary health care services and promoting the health equity of residents, but there is a paucity of evidence on equity in the allocation of GP resources in mainland China. This study explores equity in the allocation of GP resources from 2012 to 2019 in mainland China. Methods: We used GP data from 31 provinces, autonomous regions, and municipalities in mainland China. Lorenz curves, Gini coefficients, Theil indices, and agglomeration degree were used to analyze the data. Results: The total number of GPs in China was 365,082 in 2019, which corresponded to 2.61 GPs per 10,000 residents and accounted for 9.44% of the total number of practicing doctors in 2019. From 2012 to 2019, the Gini coefficient of GP allocation based on population decreased from 0.3123 to 0.1872. However, the Gini coefficient based on geographical area was maintained at 0.7108-0.7424. The Theil index of GP allocation based on population decreased from 0.0742 to 0.0270, but GP allocation based on geographical area was maintained at 0.5765-0.6898. The intra-regional contribution rates were higher than the inter-regional rates. The agglomeration degree based on geographical area and population decreased in the eastern region but increased in the central and western regions. Conclusions: The number of Chinese GPs has increased rapidly in recent years, but the distribution of GPs across China is uneven. In the western and middle regions, there is a relative shortage. Equity in the allocation of GP resources based on population was far greater than that based on geographical area. In the future, the tough issue of inequitable GP resource allocation should be resolved by comprehensive measures from a multidisciplinary perspective.