Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 28:12:1351849.
doi: 10.3389/fpubh.2024.1351849. eCollection 2024.

Identifying determinants of spatial agglomeration of healthcare resources by using spatial econometric methods: a longitudinal study in China

Enhong Dong #  1   2 , Xiaoting Sun #  1 , Yueming Xi  3 , Yijia Wang  4 , Tao Wang  5 , Weimin Gao  6
Affiliations

Identifying determinants of spatial agglomeration of healthcare resources by using spatial econometric methods: a longitudinal study in China

Enhong Dong et al. Front Public Health. .

Abstract

Background: Healthcare resources are necessary for individuals to maintain their health. The Chinese government has implemented policies to optimize the allocation of healthcare resources and achieve the goal of equality in healthcare for the Chinese people since the implementation of the new medical reform in 2009. Given that no study has investigated regional differences from the perspective of healthcare resource agglomeration, this study aimed to investigate China's healthcare agglomeration from 2009 to 2017 in China and identify its determinants to provide theoretical evidence for the government to develop and implement scientific and rational healthcare policies.

Methods: The study was conducted using 2009-2017 data to analyze health-resource agglomeration on institutions, beds, and workforce in China. An agglomeration index was applied to evaluate the degree of regional differences in healthcare resource allocation, and spatial econometric models were constructed to identify determinants of the spatial agglomeration of healthcare resources.

Results: From 2009 to 2017, all the agglomeration indexes of healthcare exhibited a downward trend except for the number of institutions in China. Population density (PD), government health expenditures (GHE), urban resident's disposable income (URDI), geographical location (GL), and urbanization level (UL) all had positive significant effects on the agglomeration of beds, whereas both per capita health expenditures (PCHE), number of college students (NCS), and maternal mortality rate (MMR) had significant negative effects on the agglomeration of institutions, beds, and the workforce. In addition, population density (PD) and per capita gross domestic product (PCGDP) in one province had negative spatial spillover effects on the agglomeration of beds and the workforce in neighboring provinces. However, MMR had a positive spatial spillover effect on the agglomeration of beds and the workforce in those regions.

Conclusion: The agglomeration of healthcare resources was observed to remain at an ideal level in China from 2009 to 2017. According to the significant determinants, some corresponding targeted measures for the Chinese government and other developing countries should be fully developed to balance regional disparities in the agglomeration of healthcare resources across administrative regions.

Keywords: China; agglomeration; determinants; healthcare resources; spatial econometric methods.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A flowchart of the methodology starting from the source of data-to-data analysis for the study (Source: Author created).
Figure 2
Figure 2
Spatial distribution patterns of healthcare resource agglomeration in China from 2009 to 2017.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Sha L, Jian G, Yongliang Y, Yaru W. The study of health resources allocation efficiency in Shaanxi province based on DEA method. Chin Health Serv Manag. (2012) 29:572–4.
    1. Gu J. A spatial study on the allocation of healthcare resource. Chin J Health Stat. (2014) 31:21–3.
    1. Horev T, Pesis-Katz I, Mukamel DB. Trends in geographic disparities in allocation of health care resources in the US. Health Policy. (2004) 68:223–32. doi: 10.1016/j.healthpol.2003.09.011, PMID: - DOI - PubMed
    1. Qiong T, Ping W. An analysis of the gap of urban-rural basic medical and health resources allocation based on GE index method–taking Chengdu as an example. Consum Econ. (2013) 29:28–31.
    1. Xie X, Wu Q, Hao Y, Yin H, Fu W, Ning N, et al. . Identifying determinants of socioeconomic inequality in health service utilization among patients with chronic non-communicable diseases in China. PLoS One. (2014) 9:1–14. doi: 10.1371/journal.pone.0100231, PMID: - DOI - PMC - PubMed

LinkOut - more resources