Spatiotemporal evolution and development path of healthcare services supply in China.

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Xiang-Min Li
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Abstract

Object: Promoting the accessibility and equity of healthcare services, as well as enhancing service capacity, are crucial for building a sound healthcare system. Particularly in the past two years of the normalized COVID-19 situation, this issue has garnered widespread attention in the academic community. This study aims to investigate and analyze the characteristics and trends of the spatial-temporal evolution of healthcare service supply levels in China. It also seeks to explore the influencing factors and pathways for development, with the goal of optimizing the allocation of healthcare resources.

Methods: This article uses the entropy weight TOPSIS method combined with Dagum Gini coefficient and Kernel density to evaluate the supply level of healthcare services in 31 provinces and cities in China from 2012 to 2020, and explores its development and spatial pattern characteristics. Then, through Moran index, panel regression model and spatial econometric testing, the spatial correlation problem and its influencing factors are further analyzed, and targeted policy recommendations are proposed based on it, laying the foundation for further promoting the balanced development of healthcare service supply capacity.

Results: (1) Healthcare services supply levels in various provinces and cities in China have significantly increased, with a shift in spatial distribution from 'higher in the east and lower in the west' to 'convergence between east and west, with lower levels in the central regions.' (2) Relative differences among regions are narrowing annually, primarily due to interactions between the four regions rather than within each region, with expanding impact of overlapping regions. (3) Absolute differences among regions are also decreasing, moving towards uniformity with a contraction of extension and a restraint on the trend towards multipolarization. (4) Spatial correlation between adjacent regions is weakening, eventually becoming non-significant, with fading spatial effects. (5) The correlation between local economic development, population factors, institutional arrangements, and the current state of supply is significant, and the research design and conclusions remain robust even after thorough consideration of spatial effects. The study explores the development pathways based on the objective existence of regional development and the controllable government actions.

Conclusion: The overall level of healthcare service supply in China has improved, but regional differences still exist. The objective level of regional development and the subjective behavior of local governments have a significant impact on the supply of healthcare services. Therefore, it is recommended that each region adapt to local conditions, identify its own strengths and weaknesses, coordinate resource supply and demand, consider the impact of key factors, and optimize the allocation of healthcare development resources.

中国医疗服务供给的时空演变与发展路径。
目的:促进医疗服务的可及性和公平性,提高服务能力,是建立健全医疗体系的关键。特别是在 COVID-19 常态化的近两年,这一问题引起了学术界的广泛关注。本研究旨在探讨和分析中国医疗卫生服务供给水平的时空演变特征和趋势。方法:本文采用熵权 TOPSIS 法,结合达古姆基尼系数和核密度,对中国 31 个省市 2012-2020 年的医疗卫生服务供给水平进行了评价,并探讨了其发展和空间格局特征。结果:(1)中国各省市医疗卫生服务供给水平显著提高,空间分布由 "东部较高、西部较低 "向 "东西部趋同、中部较低 "转变。(2)地区间的相对差异逐年缩小,主要原因是四个地区之间的相互作用,而不是每个地区内部的相互作用,重叠地区的影响不断扩大。(3) 地区间的绝对差异也在缩小,随着外延的收缩和多极化趋势的抑制而趋于一致。(4) 相邻地区之间的空间相关性减弱,最终变得不显著,空间效应逐渐消失。(5)地方经济发展、人口因素、制度安排、供给现状之间的相关性显著,即使在充分考虑空间效应后,研究设计和结论依然稳健。本研究基于区域发展的客观存在和政府行为的可控性,探索了发展路径:结论:中国医疗卫生服务供给整体水平有所提高,但地区差异依然存在。地区发展的客观水平和地方政府的主观行为对医疗服务供给有重要影响。因此,建议各地区因地制宜,明确自身优势和劣势,协调资源供需,考虑关键因素的影响,优化医疗卫生发展资源配置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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