TY  - RPRT
        AU  - Shen, Chi
AU  - Lai, Sha
AU  - Deng, Qiwei
AU  - Cao, Dan
AU  - Zhao, Dantong
AU  - Zhao, Yaxin
AU  - Zhou, Zhongliang
AU  - Dong, Wanyue
AU  - Chen, Xi
        TI  - Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China
        PY  - 2023/Jul/
        PB  - Institute of Labor Economics (IZA)
        CY  - Bonn
        T2  - IZA Discussion Paper
        IS  - 16332
        UR  - https://www.iza.org/index.php/publications/dp16332
        AB  - 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.

        KW  - primary healthcare institutions
KW  - spatial accessibility
KW  - disparities
KW  - medical service
KW  - China
        ER  -