Analysis of equity in the distribution of human resources and hospital beds and its association with the COVID-19 mortality rate: a case of Iran.

Background And Objective: Equitable distribution of health resources is important to achieving equity, guaranteeing access to healthcare services, and improving societies' health status. This study aimed to examine equity in the distribution of health resources and its association with the mortality caused by COVID-19 in South Khorasan province, east Iran.

Method: This was a secondary analysis of data from a cross-sectional study conducted in South Khorasan province in 2022. Data were drawn from an existing online database (Farabar) provided by the Public Health Department of the Ministry of Health in Iran. Data related to the number of hospital beds, medical specialists and practitioners, nurses, paramedical workers, health watch, community health workers (Behvarz), healthcare financial resources, and COVID-19 mortality rate were extracted from the Farabar system for each city separately. The equity in the distribution of resources was analyzed by calculating the Gini Coefficient index and using EXCEL software. The Gini Coefficient was used to measure the distribution of health resources and services (i.e. financial resources, human resources, hospital beds, ICU beds) against population size and geographic size. Data were analyzed using SPSS software, version 25.

Results: The Gini Coefficient ranged between 0.006 and 0.320. The Gini Coefficient of health care system financial (0.006) resources distribution was more equitable, while that of hospital beds (0.229) and intensive care beds (0.320) was more inequitable. The Gini Coefficient of the distribution of human resources was estimated at less than 0.3, which is relatively equitable. The COVID-19 mortality rate per 100,000 population was estimated at 113.6, lower than the national average. After controlling the confounding variable (rural population (as % of the total population)), there was no significant correlation between COVID-19 mortality and the distribution of human resources, hospital beds, and healthcare financial resources.

Conclusion: According to the results, the distribution of resources relative to the province's population was relatively equitable, and there was no significant correlation between the COVID-19 mortality rate and the distribution of human resources, hospital beds, and healthcare financial resources. This can be due to the equitable distribution of health resources. Having a better and deeper understanding of the regions and populations disproportionately impacted by COVID-19 can help with intervention and resource allocation.