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Optimizing the medical equipment investment in primary care centres in rural China: evidence from a panel threshold model.
Xu, Wanchun; Pan, Zijing; Zhang, Liang; Lu, Shan.
Afiliación
  • Xu W; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, 430030, Wuhan, Hubei, China.
  • Pan Z; Sun Yat-sen University Cancer Centre, Guangzhou, China.
  • Zhang L; School of Political Science and Public Administration, Wuhan University, Wuhan, China.
  • Lu S; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, 430030, Wuhan, Hubei, China. shanlu@hust.edu.cn.
BMC Health Serv Res ; 24(1): 160, 2024 Feb 01.
Article en En | MEDLINE | ID: mdl-38302957
ABSTRACT

BACKGROUND:

The previous "one-size-fits-all" practice in resource allocation can no longer adapt to the spatial variation in population and health needs. This study aimed to investigate the spatially heterogeneous effect of medical equipment investment in the township health centres in rural China to optimize the investment strategies.

METHODS:

Based on the national-scale stratified multistage cluster sampling, 319 township health centres from six provinces were included in the study. The retrospective data from 2013 to 2017 were collected for each sampled township health centres and the corresponding township community. The panel threshold regression model was applied to estimate the nonlinear effect of medical equipment increment on the service utilization due to the township communities' urbanization degree. The influence of township community remoteness on the effects of equipment increment was investigated through subgroup analysis.

RESULTS:

Among the township health centres in the neighbouring towns of the county seat (travel time to the county seat < 1 h), the significant effect of medical equipment increment was only found in the township health centres of the towns with high urbanization degrees (the proportion of the residents living in the built-up area > 69.89%), of which the effect size was 774.81 (95% CI 495.63, 1053.98, p < 0.05). Among the township health centres in the remote towns (travel time ≥ 1 h), the effect of medical equipment increment in the township health centres of the low urbanized towns (urban ≤ 5.99%, ß = 1052.54, p < 0.01) was around four times the size of that of the counterparts (urban > 5.99%, ß = 237.00, p < 0.01).

CONCLUSION:

This study demonstrated the spatially heterogeneous effect of medical equipment investment in the primary care centres in rural China. The priority of the equipment investment was suggested to be given to the township health centres in the remote towns with a low urbanization degree and those in the highly-urbanized neighbouring towns of the county seats.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Población Rural / Urbanización Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Asia Idioma: En Año: 2024 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Población Rural / Urbanización Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Asia Idioma: En Año: 2024 Tipo del documento: Article