Leaving home for health care: An examination of the determinants of intercity patient mobility for obstetric care in Hubei Province, China using spatial econometric models

Abstract

The uneven distribution of high-quality medical resources and intercity patient mobility have attracted increasing attention. However, evidence from developing contexts such as China remains limited, and the multidimensional determinants of these patterns are not yet well understood. On the basis of obstetric inpatient records in Hubei Province, a push–pull–barrier framework and spatial econometric models are used to examine the determinants of intercity patient mobility for obstetric care at tertiary hospitals. The results reveal that 6.30% of obstetric patients seek care across prefecture boundaries. As the provincial center that attracts patients from elsewhere, Wuhan plays a pronounced role, and the areas surrounding Wuhan experience high ratios of intercity patient mobility. Spatial econometric analyses demonstrate that insufficient local medical resources, long travel distances to local hospitals, and proximity to regional medical centers significantly promote intercity patient mobility, whereas limited insurance support and poor transportation accessibility act as institutional and geographical barriers. These findings provide policy insights for the governance of cross-regional patient mobility and the regional planning of medical resources, particularly in the context where medical resources are highly concentrated and medical insurance is administratively fragmented.