Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China
Abstract Background With the progress of economic and social development, the demand for healthcare has increased, making the rational allocation of health resources and the efficient utilization of services crucial for public health. However, mismatches between resource allocation and service utili...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22916-9 |
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| author | Xiaomin Xu Zilin Han Qing Liang Mengmeng Hu Qiaoli Chen Wenli Fang Zhangman Ma Sixian Zhou Zhicheng Liu Xiangyang Gong |
| author_facet | Xiaomin Xu Zilin Han Qing Liang Mengmeng Hu Qiaoli Chen Wenli Fang Zhangman Ma Sixian Zhou Zhicheng Liu Xiangyang Gong |
| author_sort | Xiaomin Xu |
| collection | DOAJ |
| description | Abstract Background With the progress of economic and social development, the demand for healthcare has increased, making the rational allocation of health resources and the efficient utilization of services crucial for public health. However, mismatches between resource allocation and service utilization have led to strain on resources. This study aims to assess the spatiotemporal evolution and influencing factors of the coupling coordination between health resource allocation (HRA) and health service utilization (HSU) in China, contributing to the realization of the "Healthy China" strategy. Methods Based on the panel data from 2010 to 2022, The entropy method is employed to measure the comprehensive development index of HRA and HSU. The Coupling Coordination Degree Model (CCDM) was used to measure the coupling coordination degree (CCD)of HRA and HSU. The standard deviation ellipse (SDE) and kernel density estimation (KDE) to find the gravity centers movement trends and dynamic evolution of CCD. The XGBoost-SHAP machine learning was used to explore the key factors affecting CCD. Results (1) The comprehensive development levels of the subsystems of HRA and HSU showed an overall upward trend, but they do not rise simultaneously. (2) CCD exhibited a stable upward trend over time, with higher values in the south and east, and lower values in the north and west. (3) The spatial migration of CCD was centered in Henan Province, with shifts from northwest to southwest to northeast, and after initial fluctuations, the distribution became more concentrated, and polarization diminished. (4) CCD is primarily influenced by healthcare investment and economic development. Additionally, influencing factors exhibit regional heterogeneity: in the eastern region, URRBMI coverage positively impacts CCD; in the central region, traffic network density positively influences CCD; and in the western region, population density negatively affects CCD. Conclusions This study investigates the spatiotemporal evolution and influencing factors of CCD, suggesting that governments adopt differentiated strategies to enhance CCD and offering a theoretical foundation for implementing the "Healthy China" strategy. |
| format | Article |
| id | doaj-art-723255bcb88040aa9ec7ca36b6412877 |
| institution | OA Journals |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-723255bcb88040aa9ec7ca36b64128772025-08-20T01:51:41ZengBMCBMC Public Health1471-24582025-05-0125111710.1186/s12889-025-22916-9Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in ChinaXiaomin Xu0Zilin Han1Qing Liang2Mengmeng Hu3Qiaoli Chen4Wenli Fang5Zhangman Ma6Sixian Zhou7Zhicheng Liu8Xiangyang Gong9Department of Public Health, Hangzhou Medical CollegeDepartment of Environmental Science and Engineering, Fudan UniversityDepartment of Public Health, Hangzhou Medical CollegeDepartment of Public Health, Hangzhou Medical CollegeZhejiang Provincial Medical Service Management and Evaluation CenterThe Second Clinical Medical College of, Hangzhou Normal University (Zhejiang Provincial People’s Hospital)The Second School of Clinical Medicine, Zhejiang Chinese Medical UniversityThe Second School of Clinical Medicine, Zhejiang Chinese Medical UniversityThe Second School of Clinical Medicine, Zhejiang Chinese Medical UniversityDepartment of Radiology, Center for Rehabilitation Medicine, Zhejiang Provincial People’s HospitalAbstract Background With the progress of economic and social development, the demand for healthcare has increased, making the rational allocation of health resources and the efficient utilization of services crucial for public health. However, mismatches between resource allocation and service utilization have led to strain on resources. This study aims to assess the spatiotemporal evolution and influencing factors of the coupling coordination between health resource allocation (HRA) and health service utilization (HSU) in China, contributing to the realization of the "Healthy China" strategy. Methods Based on the panel data from 2010 to 2022, The entropy method is employed to measure the comprehensive development index of HRA and HSU. The Coupling Coordination Degree Model (CCDM) was used to measure the coupling coordination degree (CCD)of HRA and HSU. The standard deviation ellipse (SDE) and kernel density estimation (KDE) to find the gravity centers movement trends and dynamic evolution of CCD. The XGBoost-SHAP machine learning was used to explore the key factors affecting CCD. Results (1) The comprehensive development levels of the subsystems of HRA and HSU showed an overall upward trend, but they do not rise simultaneously. (2) CCD exhibited a stable upward trend over time, with higher values in the south and east, and lower values in the north and west. (3) The spatial migration of CCD was centered in Henan Province, with shifts from northwest to southwest to northeast, and after initial fluctuations, the distribution became more concentrated, and polarization diminished. (4) CCD is primarily influenced by healthcare investment and economic development. Additionally, influencing factors exhibit regional heterogeneity: in the eastern region, URRBMI coverage positively impacts CCD; in the central region, traffic network density positively influences CCD; and in the western region, population density negatively affects CCD. Conclusions This study investigates the spatiotemporal evolution and influencing factors of CCD, suggesting that governments adopt differentiated strategies to enhance CCD and offering a theoretical foundation for implementing the "Healthy China" strategy.https://doi.org/10.1186/s12889-025-22916-9Health resource allocationHealth service utilizationCoupling coordination degreeStandard deviation ellipseKernel density estimationInfluencing factors |
| spellingShingle | Xiaomin Xu Zilin Han Qing Liang Mengmeng Hu Qiaoli Chen Wenli Fang Zhangman Ma Sixian Zhou Zhicheng Liu Xiangyang Gong Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China BMC Public Health Health resource allocation Health service utilization Coupling coordination degree Standard deviation ellipse Kernel density estimation Influencing factors |
| title | Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China |
| title_full | Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China |
| title_fullStr | Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China |
| title_full_unstemmed | Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China |
| title_short | Spatial differences, dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in China |
| title_sort | spatial differences dynamic evolution and influencing factors of the coupling and coordination relationship between health resources allocation and health service utilization in china |
| topic | Health resource allocation Health service utilization Coupling coordination degree Standard deviation ellipse Kernel density estimation Influencing factors |
| url | https://doi.org/10.1186/s12889-025-22916-9 |
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