Tianqi Wang ¹ Ting Zhou ¹ Leming Zhou ² Yunfei He ³ Jian Wang ⁴ Yonghong Wang ⁵ Li Huang ^3*

• ¹ School of Public Health, Chongqing Medical University, Chongqing, China
• ² College of Computer Science and Technology, Chongqing University of Posts and Telecommunications, Chongqing, Chongqing, China
• ³ Department of Personnel, First Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing Municipality, China
• ⁴ Department of Pathophysiology, Chongqing Medical University, Chongqing, China
• ⁵ Department of Clinical Laboratory, Chongqing Qianjiang Central Hospital, Qianjiang, Chongqing, China

Objective：This study aimed to evaluate the fairness and efficiency of health resource allocation (HRAE) in Chengdu-Chongqing Economic Circle after the new healthcare reform. This study also aimed to identify existing problems, providing empirical evidence for the government to formulate regional health plans scientifically and reasonably.Methods：The fairness of health resource allocation was analyzed using the Gini coefficient, Theil index, and agglomeration degree from population and geographical area perspectives.The three-stage data envelopment analysis and the Malmquist productivity index were used to analyze HRAE from static and dynamic perspectives.Results：The Gini coefficient for population allocation in Chengdu-Chongqing Economic Circle was 0.066-0.283, and the Gini coefficient for geographical area allocation was 0.297-0.469. The contribution rate within a region was greater than that between regions, and health resources were mainly concentrated in economically developed core areas. The overall fairness of Chengdu Economic Circle was relatively better than that of Chongqing Economic Circle. Moreover, the adjusted mean technical efficiency was 0.806, indicating room for HRAE improvement in Chengdu- Chongqing Economic Circle. Stochastic Frontier Analysis found that different environmental variables have varying degrees of impact on HRAE. The adjusted mean total factor productivity change (Tfpch) was 1.027, indicating an overall upward trend in HRAE since the new healthcare reform. However, scale efficiency change (Sech) (0.997) limited the improvement of Tfpch.Conclusion：The fairness of health resources allocated by population was better than that allocated by geographical area. The unfairness of health resources mainly stemmed from intra-regional differences, with considerable health resources concentrated in core areas. Over the past 13 years, HRAE has improved but exhibited spatial heterogeneity and Sech-hindered productivity improvement. The study recommends strengthening regional cooperation and sharing to promote the integrated and high-quality development of the health and well-being in Chengdu-Chongqing Economic Circle. This study utilized panel data from 44 districts in Chengdu-Chongqing Economic Circle from 2009 to 2021 for empirical analysis. The data originates from the healthcare reform in 2009 and continues through the later stage of the 11th Five-Year Plan to the beginning of the 14th Five-Year Plan. This duration was a critical period for promoting the construction of a healthy China and