Lin Yingying, Chen Guozhi, Lu Huaxiang, Qin Rongfei, Jiang Jinsheng, Tan Weiwei, Luo Caibin, Chen Ming, Huang Qin, Huang Liangliang, Dong Aihu, Qin Jian
School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China.
Guangxi Zhuang Autonomous Region Disabled Rehabilitation Research Center, 48 Luowen Road, Nanning, Guangxi Zhuang Autonomous Region, China.
BMC Public Health. 2025 May 7;25(1):1677. doi: 10.1186/s12889-025-22871-5.
In recent years, medical interventional treatment for children with autism spectrum disorder (ASD) has been gradually introduced in medical institutions in the Guangxi Zhuang Autonomous Region in southern China. However, the allocation of these medical resources has been uneven. This study describes the spatial allocation of medical resources for children with ASD in Guangxi, evaluates their supply and utilization, and expounds on their correlations with socioeconomic and demographic conditions.
This study was based on a special survey conducted from 2021 to 2022 by the Guangxi Disabled Rehabilitation Research Center. The number of medical institutions for children with ASD (MIIs), average number of ASD technicians per 10,000 target people (CTPP), and coverage rate of medical interventions (CMI) were set as dependent variables, while population density, proportion of town residents, total retail sales of consumer goods, disposable income per capita gross domestic product per capita (GDPpc), and number of enterprises above designated size were set as independent variables, all of which were included in the spatial statistical model. The main analysis methods was multiscale geographically weighted regression (MGWR).
The allocation of MIIs (Moran's I = 0.119, p = 0.007), CTPP (Moran's I = 0.208, p = 0.017), and CMI (Moran's I = 0.251, p = 0.004) in Guangxi showed significant spatial autocorrelation. The medical resources formed high-value hot spots in major districts of core cities, while the medical resources were scarce in some remote ethnic minority counties and densely populated areas in southeastern Guangxi. MIIs showed significant spatial correlations with population density (EV=-0.225, p = 0.001), proportion of town residents (EV = 0.255, p = 0.002), total retail sales of consumer goods (EV = 0.806, p < 0.001), and disposable income per capita (EV=-0.267, p < 0.001). CTPP showed significant correlations with population density (EV = 0.211, p = 0.019), GDPpc (EV = 0.267, p = 0.002), total retail sales of consumer goods (EV = 0.382, p < 0.001), and number of enterprises above designated size (EV=-0.242, p = 0.005). CMI showed a significant association with proportion of town residents (EV = 0.415, p < 0.001), total retail sales of consumer goods (EV = 0.273, p = 0.006), and number of enterprises above designated size (EV=-0.236, p = 0.003).
The spatial allocation of medical resources for children with ASD in Guangxi is heterogeneous, and correlates varyingly with regional socioeconomic conditions as well as urbanization and demographic conditions.
近年来，中国南方广西壮族自治区的医疗机构逐渐引入了针对自闭症谱系障碍（ASD）儿童的医学介入治疗。然而，这些医疗资源的分配并不均衡。本研究描述了广西ASD儿童医疗资源的空间分配情况，评估了其供应和利用情况，并阐述了它们与社会经济和人口状况的相关性。
本研究基于广西残疾人康复研究中心在2021年至2022年进行的一项专项调查。将自闭症谱系障碍儿童医疗机构数量（MIIs）、每万名目标人群中的自闭症谱系障碍技术人员平均数量（CTPP）和医疗干预覆盖率（CMI）设为因变量，将人口密度、城镇居民比例、社会消费品零售总额、人均可支配收入、人均国内生产总值（GDPpc）和规模以上企业数量设为自变量，将所有这些纳入空间统计模型。主要分析方法是多尺度地理加权回归（MGWR）。
广西的MIIs（莫兰指数I = 0.119，p = 0.007）、CTPP（莫兰指数I = 0.208，p = 0.017）和CMI（莫兰指数I = 0.251，p = 0.004）的分配显示出显著的空间自相关性。医疗资源在核心城市的主要城区形成了高值热点，而在一些偏远的少数民族县和广西东南部人口密集地区，医疗资源稀缺。MIIs与人口密度（估计系数EV = -0.225，p = 0.001）、城镇居民比例（EV = 0.255，p = 0.002）、社会消费品零售总额（EV = 0.806，p < 0.001）和人均可支配收入（EV = -0.267，p < 0.001）显示出显著的空间相关性。CTPP与人口密度（EV = 0.211，p = 0.019）、GDPpc（EV = 0.267，p = 0.002）、社会消费品零售总额（EV = 0.382，p < 0.001）和规模以上企业数量（EV = -0.242，p = 0.005）显示出显著相关性。CMI与城镇居民比例（EV = 0.415，p < 0.001）、社会消费品零售总额（EV = 0.273，p = 0.006）和规模以上企业数量（EV = -0.236，p = 0.003）显示出显著关联。
广西自闭症谱系障碍儿童医疗资源的空间分配存在异质性，且相关性因地区社会经济状况以及城市化和人口状况而异。
