%0 Report
        %A Shen, Chi
%A Lai, Sha
%A Deng, Qiwei
%A Cao, Dan
%A Zhao, Dantong
%A Zhao, Yaxin
%A Zhou, Zhongliang
%A Dong, Wanyue
%A Chen, Xi
        %T Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China
        %D 2023
        %8 2023 Jul
        %I Institute of Labor Economics (IZA)
        %C Bonn
        %7 IZA Discussion Paper
        %N 16332
        %U https://www.iza.org/index.php/publications/dp16332
        %X 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.

        %K primary healthcare institutions
%K spatial accessibility
%K disparities
%K medical service
%K China