Will urban scale affect health services inequity? The empirical evidence from cities in China

BackgroundThe equity of public resources triggered by city shrinkage is a global challenge. Significantly, the impact of city shrinkage on the allocation of health service resources needs to be better understood. This study explores the impact of population change on government investment and health...

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Main Authors: Hongchuan Wang (Author), Kaibo Xu (Author), Handong Fang (Author), Hui Lin (Author), Huatang Zeng (Author)
Format: Book
Published: Frontiers Media S.A., 2024-07-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Hongchuan Wang  |e author 
700 1 0 |a Kaibo Xu  |e author 
700 1 0 |a Handong Fang  |e author 
700 1 0 |a Hui Lin  |e author 
700 1 0 |a Huatang Zeng  |e author 
700 1 0 |a Huatang Zeng  |e author 
245 0 0 |a Will urban scale affect health services inequity? The empirical evidence from cities in China 
260 |b Frontiers Media S.A.,   |c 2024-07-01T00:00:00Z. 
500 |a 2296-2565 
500 |a 10.3389/fpubh.2024.1330921 
520 |a BackgroundThe equity of public resources triggered by city shrinkage is a global challenge. Significantly, the impact of city shrinkage on the allocation of health service resources needs to be better understood. This study explores the impact of population change on government investment and health service delivery in shrinking cities.Data and methodUsing data from China's Urban Statistical Yearbook (2010-2020), we employ regression discontinuity (RD) and fixed-effect models to examine the causal relationship between city shrinkage and health service provision.ResultShrinking cities show significant disparities in health resources, particularly in bed numbers (−1,167.58, p < 0.05) and doctor availability (−538.54, p < 0.05). Economic development (p < 0.01) and financial autonomy (p < 0.01) influence hospital bed distribution. Investments in public services (primary schools and teachers, p < 0.01) affect health resource delivery. Robustness tests support our results.ConclusionThis study reveals how city shrinkage disrupts health service provision and equity, establishing a causal relationship between city shrinkage/expansion and health resource allocation, emphasizing the imbalance caused by urban population changes. City expansion intensifies competition for health resources, while shrinking cities struggle to provide adequate resources due to government reluctance. Policymakers should adapt health resource allocation strategies to meet patient demands in changing urban landscapes. 
546 |a EN 
690 |a city shrinkage 
690 |a health service 
690 |a equity 
690 |a resource allocation 
690 |a population change 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Frontiers in Public Health, Vol 12 (2024) 
787 0 |n https://www.frontiersin.org/articles/10.3389/fpubh.2024.1330921/full 
787 0 |n https://doaj.org/toc/2296-2565 
856 4 1 |u https://doaj.org/article/dc3e8f5e28a643038ab35f01ef21f39a  |z Connect to this object online.