College of Economics and Management, China Agricultural University, Beijing, 100083, China.
Academy of Global Food Economics and Policy, China Agricultural University, Beijing, China.
BMC Health Serv Res. 2024 Aug 29;24(1):1004. doi: 10.1186/s12913-024-11436-8.
The incongruity between the regional supply and demand of healthcare services is a persistent challenge both globally and in China. Patient mobility plays a pivotal role in addressing this issue. This study aims to delineate the cross-provincial inpatient mobility network (CIMN) in China and identify the underlying factors influencing this CIMN.
We established China's CIMN by applying a spatial transfer matrix, utilizing the flow information from 5,994,624 cross-provincial inpatients in 2019, and identified the primary demand and supply provinces for healthcare services. Subsequently, we employed GeoDetector to analyze the impact of 10 influencing factors-including medical resources, medical quality, and medical expenses-on the spatial patterns of CIMN.
Beijing, Shanghai, Zhejiang, and Jiangsu provinces are the preferred medical destinations for cross-provincial inpatients, while Anhui, Henan, Hebei, and Jiangsu provinces are the main sources for cross-provincial inpatients. Patient flow between provinces decreases with distance. The spatial distribution of medical resources, medical quality, and medical expenses account for 87%, 73%, and 56% of the formation of CIMN, respectively. Additionally, interactions between these factors enhance explanatory power, suggesting that considering their interactions can more effectively optimize medical resources and services.
The analysis of CIMN reveals the supply and demand patterns of healthcare services, providing insights into the inequality characteristics of healthcare access. Furthermore, understanding the driving factors and their interactions offers essential evidence for optimizing healthcare services.
全球和中国都存在医疗服务区域供需不匹配的问题。患者流动在解决这一问题方面起着关键作用。本研究旨在描绘中国的跨省级住院患者流动网络（CIMN），并确定影响这一 CIMN 的潜在因素。
我们通过应用空间转移矩阵，利用 2019 年 5994624 名跨省级住院患者的流量信息，建立了中国的 CIMN，并确定了医疗服务的主要需求和供应省份。随后，我们采用 GeoDetector 分析了 10 个影响因素（包括医疗资源、医疗质量和医疗费用）对 CIMN 空间格局的影响。
北京、上海、浙江和江苏是跨省级住院患者的首选医疗目的地，而安徽、河南、河北和江苏则是跨省级住院患者的主要来源地。省际间的患者流动随着距离的增加而减少。医疗资源、医疗质量和医疗费用的空间分布分别占 CIMN 形成的 87%、73%和 56%。此外，这些因素之间的相互作用增强了解释能力，表明考虑它们的相互作用可以更有效地优化医疗资源和服务。
CIMN 的分析揭示了医疗服务的供需模式，为了解医疗可及性的不平等特征提供了线索。此外，了解驱动因素及其相互作用为优化医疗服务提供了重要证据。
