Spatial-temporal Differences Of Medical Resources Across Chinese Prefecture-level Cities And Their Influencing Factors

With the outbreak of COVID-19,the problem of inequity of medical resources has become increasingly severe.As a public resource,medical and health resources are related to the national economy and the people’s livelihood.It is a major social infrastructure project related to the vital interests of the people.Therefore,it is urgent to correctly understand and solve the problem of inequity of medical resources in Chinese cities.This study takes 291 cities at prefecture level and above in China as the research object,analyzes the temporal and spatial differentiation pattern of medical resource level at prefecture level city level from 2014 to 2019,uses the method of spatial regression to identify its influencing factors,and puts forward targeted policy suggestions.The main findings of the study are as follows:(1)The level of urban medical resources in China showed an upward trend during the study period,and the overall medical level has been effectively improved.There is an unfair phenomenon in the allocation of urban medical resources in China,but the overall fairness is on the rise.(2)The distribution of urban medical resources in China shows a pattern of more in the East and less in the west,more in the north and less in the south,and the degree of differentiation in the north-south direction is greater than that in the east-west direction.(3)The Gini coefficient of medical resources in 35 large and medium-sized cities and provinces is lower than 0.2,which belongs to a high average.The Gini coefficient of medical resources in 291 prefecture level cities and cities in the East,middle and west regions is between 0.2-0.29,which is relatively average.In terms of the overall change trend of equity level,the change trend of central cities,western cities and 291 prefecture level cities is basically the same,and the change trend of eastern cities and35 large and medium-sized cities is basically the same.The equity of urban medical resource allocation in the East,middle and West decreases in turn,and the equity of urban medical resource allocation in the central region is the most significant.(4)Among the factors affecting the level of medical resources,per capita GDP,general public expenditure per 10000 people,number of insured people per 10000 people,population,education expenditure per 10000 people,proportion of construction land,industrial sulfur dioxide emission,urbanization rate and urban grade have direct effects.Per capita GDP,number of insured people per 10000 people,population,proportion of construction land,urbanization rate and Urban grade have indirect(spillover)effects.Per capita GDP,general public expenditure per 10000 people,number of insured persons per 10000 people,proportion of construction land,industrial sulfur dioxide emission,urbanization rate and urban grade have total effects.In view of the findings of the study,this paper also puts forward policy suggestions on improving the proportion of government health expenditure,improving the implementation of hierarchical diagnosis and treatment system,and promoting peoplecentered urbanization,hoping to provide help within our ability to improve the fairness of urban medical resource allocation and promote the equalization of public services in China.