Physician distribution across China's cities: regional variations

Area of Science:

• Health Services Research
• Urban Studies
• Public Health Policy

Background:

• Physician distribution is vital for healthcare access, with limited research on urban variations.
• China's rapid urbanization presents unique challenges for equitable physician distribution.
• This study examines physician density variations across over 600 Chinese cities.

Purpose of the Study:

• To analyze the heterogeneity of physician density across diverse urban areas in China.
• To identify factors influencing physician distribution within urban settings.
• To inform policies aimed at improving healthcare access in rapidly urbanizing regions.

Main Methods:

• Utilized data from National Census Surveys and China statistical yearbooks (2000-2003, 2010-2013).
• Characterized cities by administrative level, geographic region, and urban agglomeration status.
• Employed generalized estimating equations with an ordinal logistic linking function to analyze physician supply variations.

Main Results:

• Physician density declined in urban China between 2003 and 2013, after adjusting for population and socioeconomic factors.
• Urban districts generally had higher physician density than county-level cities, with notable regional differences.
• No significant difference in physician density was observed between cities within and outside urban agglomerations.

Conclusions:

• Physician density growth did not consistently match population health demand changes, indicating potential access issues.
• Reduced inequality in physician distribution was observed, but disparities persist.
• Assessing physician distribution requires consideration of population heterogeneity and socioeconomic characteristics.