AUTHOR=Tu Chenglin , Zeng Yonghui , Long Hongyu , Yu Chenyang , Tan Yuanfang , Zhou Yu , Zang Chuanxiang 

TITLE=Regional integration and public healthcare environment: Evidence from China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1013053

DOI=10.3389/fpubh.2022.1013053

ISSN=2296-2565

ABSTRACT=Existing studies have focused on the impact of economic development and urban expansion on public healthcare environment but has ignored the importance of regional integration. Regional integration reflects the spatial distribution of the labor force, which significantly affects healthcare workforce and healthcare infrastructure development. Based on panel nested data for 137 cities in 16 major city clusters in China from 2001 to 2019, this paper assesses the impact of regional integration on the public healthcare environment through a hierarchical linear model (HLM). Our findings indicate that a 1% increase in regional integration leads to a 6.6% and 1.9% improvement in healthcare workforce and healthcare infrastructure. The results of the mechanism analysis indicate that regional integration affects the public healthcare environment through improving transportation infrastructure and industrial upgrading. In addition, regional integration has a stronger effect on the public healthcare environment in core cities than in peripheral cities. Meanwhile, heterogeneity analysis shows that regional integration has stronger improvement effects on cities with lower levels of economic development and health care environments. Finally, the endogeneity test based on the difference-in-difference (DID) model and the robustness test based on high-dimensional fixed effects model conduct the consistent conclusions. Policies to improve the public healthcare environment through promoting regional integration are proposed.