Equality assessment of radiotherapy / diagnosis resources allocation in Shanghai

Objective To evaluate the equity of medical resources in radiotherapy/diagnosis in Shanghai based on population, geography, and economic factors. Methods Data on medical resources including institutions, equipment, and staff in radiotherapy/diagnosis were collected from all 16 districts of Shanghai in 2022. Separate data were collected for institutions and devices in X-CT. The Gini coefficient (G) and Lorenz curves were used to assess fairness based on population and geography, while the Theil index (T) was employed to evaluate health equity based on economic factors. Health resource agglomeration degree (HRAD) and population agglomeration degree (PAD) were utilized to analyze the equity and accessibility of medical resources considering both population and geography. Results In 2022, Shanghai had a total of 992 institutions, 4925 devices, and 10,282 personnel in radiotherapy/diagnosis. Additionally, there were 381 institutions conducting X-CT examinations and 776 X-CT machines in Shanghai. The Gini coefficients for institutions, devices, and personnel in radiotherapy/diagnosis based on population ranged from 0.2 to 0.4, while for X-CT, the Gini coefficients for institutions and devices ranged from 0.2 to 0.4. When considering geography, all Gini coefficients were greater than 0.5. The results of the Theil index indicated that inequities in distribution may be influenced by economic factors. The HRAD and PAD revealed disparities in the accessibility of institutions, devices, and personnel in radiotherapy/diagnosis and X-CT in Shanghai. Conclusions Inequities in the distribution of institutions, equipment, and personnel for radiotherapy/diagnosis and X-CT were observed in Shanghai in 2022, both geographically and economically. There is a critical need to enhance the allocation of resources for radiological equipment and personnel and to establish a scientifically robust urban resource planning framework.