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ORIGINAL RESEARCH article

Front. Public Health

Sec. Health Economics

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1642295

This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health Welfare, Volume IIView all 6 articles

Joint spatiotemporal evaluation of multiple healthcare resources: hospitals, hospital beds and physicians across 365 Chinese cities over 22 years

Provisionally accepted
Xin  QiXin Qi1Mingyu  XieMingyu Xie1Yaqian  HeYaqian He2Xianteng  TangXianteng Tang3Lingfeng  LiaoLingfeng Liao4Yaling  LuoYaling Luo4Kaiwei  LinKaiwei Lin3Xiang  YanXiang Yan5Xiuli  WangXiuli Wang4Yuanyuan  ZhuYuanyuan Zhu4Zhangying  TangZhangying Tang3Yumeng  ZhangYumeng Zhang6*Chao  SongChao Song6*Jay  PanJay Pan4
  • 1School of Public Health,, Xi'an Jiaotong University, Xi'an, China
  • 2Department of Geosciences, University of Arkansas, Fayetteville, United States
  • 3State Key Laboratory of Oil and Gas Reservoir Geology and Exploitation, School of Geoscience and Technology, Southwest Petroleum University, Chengdu, China
  • 4HEOA–West China Health & Medical Geography Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
  • 5College of Architecture and Environment, Institute of Urbanization Strategy and Architecture Research, Sichuan University, Chengdu, China
  • 6Institute for Healthy Cities and West China Research Centre for Rural Health Development, Sichuan University, Chengdu, China

The final, formatted version of the article will be published soon.

Regional disparities in healthcare resource allocation across space and time present significant challenges to the global achievement of SDG 3, SDG 10, and SDG 11. To this end, we propose a joint spatiotemporal evaluation framework to assess the synergistic efficiency of multiple healthcare resource indicators.Using China as a case study, we analyzed data from 365 cities on three key healthcare resource indicators: hospitals, hospital beds, and physicians. A composite healthcare resource score was constructed using the entropy weight method. We developed a three-dimensional joint spatiotemporal evaluation framework incorporating spatial Gini coefficient, emerging hotspot analysis, and Bayesian Spatiotemporally Varying Coefficients (BSTVC) model with Spatiotemporal Variance Partitioning Index (STVPI) to evaluate spatiotemporal equity, agglomeration and influencing factors. Individual indicators were evaluated to validate the framework's robustness.(i) Spatiotemporal description: The composite indicator, weighted by hospitals (25%), hospital beds (46%), and physicians (29%), showed only a modest increase from 2000 to 2021, with persistently lower values in western and northern regions. (ii) Common spatiotemporal equity: The spatial Gini coefficient for the composite indicator increased annually by 0.34%, mirroring trends in hospital beds (0.34%) and physicians (0.26%) but contrasting with hospitals (-0.32%). This suggested declining equity was mainly driven by hospital beds and physicians, partially offset by the more balanced distribution of hospitals. (iii) Common spatiotemporal agglomeration: Hotspot intensity for the composite indicator was lower than that for hospitals but higher than for hospital beds and physicians. Cold spots were more concentrated for the composite indicator than for any individual indicator, with less than 10% overlap across the three indicators, indicating weak regional synergy. (iv) Common spatiotemporal drivers: BSTVC and STVPI methods revealed consistent patterns of explainable percentages across four healthcare resource indicators, with population density (37.96%, 95% CI: 30.05-43.05%) and employed population density (31.63%, 30.69-33.83%) emerging as dominant common drivers, supporting unified and coordinated policy interventions.We proposed a joint spatiotemporal evaluation framework to quantify both common and differentiated allocation patterns and driving factors across multiple healthcare resource indicators, highlighting the need for type-specific, temporally responsive, and spatially adaptive interventions to support dynamic monitoring and precise regulation of regional healthcare resource allocation over the globe.

Keywords: regional healthcare resource, Multiple indicators, joint spatiotemporal evaluation, Spatiotemporal heterogeneity, healthy cities, sdg, China

Received: 06 Jun 2025; Accepted: 05 Aug 2025.

Copyright: © 2025 Qi, Xie, He, Tang, Liao, Luo, Lin, Yan, Wang, Zhu, Tang, Zhang, Song and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Yumeng Zhang, Institute for Healthy Cities and West China Research Centre for Rural Health Development, Sichuan University, Chengdu, China
Chao Song, Institute for Healthy Cities and West China Research Centre for Rural Health Development, Sichuan University, Chengdu, China

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