A Descriptive Study on Attitudes Toward Local Health Resource Allocation: The Case of Chongqing Province in China

Abstract

Background: The variance of attitudes among stakeholders of health resource allocation has rarely been reported because health officials play a dominant role in most countries with implicit rationing. Objectives: The aim of this descriptive study is to explore the priority-setting value in local health resource allocation in the province of Chongqing, China. Methods: To test the local health rationing values in Chongqing, a survey was conducted on attitudes through a self-administered Likert scale questionnaire. The data were collected from February 1, 2013 to August 30, 2016. Attitudes among respondents (174 health officials and 480 health workers) were analyzed and compared through convenience sampling with the help of the local health bureau by using IBM SPSS Statistics 21.0. Results: The mean values of officials' self-perception and health workers' assessment were opposite, with a coherent and optimistic perception from officials (most mean values > 4) versus a varied and pessimistic evaluation among health workers (most mean values < 3). Officials ranked highly on the severity of the disease, the fair distribution of resources, and public satisfaction, while health workers gave all the items of the questionnaires below 3 points. Officials ranked deemed the procedural process fair and officials depended more on themselves and public hospitals for health rationing, while the health workers prefer media and scholars. Value-based preferences for priority setting between the two groups were quite different. Conclusions: The study concludes that local health rationing in Chongqing is a matter of political and value preference rather than an evidence-based decision. Officials were not willing to share their rationing power, and the lower evaluation of health workers than officials' assessment may result from insufficient participation.