Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/279030 
Year of Publication: 
2023
Series/Report no.: 
IZA Discussion Papers No. 16332
Publisher: 
Institute of Labor Economics (IZA), Bonn
Abstract: 
Primary healthcare institutions (PHIs) in China have experienced a sizable decline in medical services in recent years. Despite the large regional disparities in China, there is a lack of evidence on the differential patterns of medical services offered by PHIs, especially from a spatial perspective. This study examines whether residents in more remote areas use more medical services offered by township healthcare centers (THCs), a main type of PHIs. Linking medical visits to 923 THCs in a western Chinese province in 2020 with the driving time and geographic coordinates from the Gaode map, a leading map navigation provider in China, we applied a multilevel linear model and a geographically weighted regression to examine spatial heterogeneity in medical service utilization. We showed that a one-hour increase in the shortest driving time between THCs and the local county hospitals was associated with an average 6% increase in THCs outpatient visits and a 0.6% increase in THCs inpatient visits. Our findings suggest that THCs located in more remote areas provided more medical services, especially outpatient services.
Subjects: 
primary healthcare institutions
spatial accessibility
disparities
medical service
China
JEL: 
I11
I14
I18
R53
Document Type: 
Working Paper

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