Spatial characteristics and influential mechanism of the coupling coordination degree of urban accessibility and human development index in China

Impact of provincial economic development levels on public-private hospital co-development in China: an empirical analysis

INTRODUCTION

The co-development of public-private hospitals in China's healthcare system significantly influences the system's service utilisation, but the public-private hospital interaction is poorly understood. Bridging this knowledge gap is crucial for informed policy-making and promoting a more balanced healthcare system. This study measures China's public-private hospital co-development and the impact of provincial and regional economic development levels on public-private hospital co-development.

METHODS

We use service utilisation, a comprehensive measure of resource allocation, service capacity and service efficiency, to assess the co-development of China's public and private hospitals. Using the coupling coordination degree model, a novel approach borrowed from physics, we measured the degree of interaction between the public and private pillars of China's hospital system. Second, we measured the relationship between the degree of private-public hospital interaction and the level of provincial-regional economic development, including provincial direct and spillover effects. Data were collected on 2011-2021 service utilisation across 31 Chinese provinces. Fixed-effect models and the spatial Durbin model estimated the direct and spillover effects between the coupling coordination degree and the level of provincial economic development.

RESULTS

We found that national, regional and provincial service utilisation in private hospitals expanded, while service utilisation remained constant in public hospitals. China's private-public hospital co-development improved from the 'barely co-developed' (0.696 in 2011) to the 'partially co-developed' level (0.752 in 2021) in the public-private transitional co-development stage. We identified significant regional heterogeneity, with the eastern region co-development slightly better than the central region and both substantially better than the western region. There was also significant provincial heterogeneity. Increases in regional and provincial economic development promoted the service utilisation of private hospitals, improving the balanced co-development of public-private hospitals in the home and adjacent provinces (p<0.05).

CONCLUSIONS

To improve the co-development of public-private hospitals and avoid regional imbalances, regional and provincial hospital policies and regulations should be coordinated and equitable; private hospitals should cooperate with public hospitals through their professional management teams and medical equipment sharing to equalise medical resource allocations; and regional economic disparities should be addressed.

Analysis of railway accessibility in Fujian Province and the influence of economic development on its spatial differentiation

Understanding railway accessibility supports railway regulation and development, but few studies consider different perspectives. We study the spatial distribution of accessibility indicators at the county (city) scale in Fujian Province by spatiotemporal syntax and weighted average travel time using railway timetable data. Export trade, rich commercial activities, and high-speed rail had a significant positive effect on objective accessibility. Fuzhou, Sanming, and Longyan were main transfer centers. The most accessible nodes based on weighted average travel time formed a "U"-shaped corridor along the coast. The county-wide average accessibility was 1.72 h. According to spatiotemporal syntax, local general public budget expenditure (0.758993) and export volume of goods-total retail sales of consumer goods (0.956257) had the most interactive impact, while according to weighted average accessibility, import volume of goods (0.618447) and per capita gross regional product-import volume of goods (0.878573) did. These results provide reference for transportation planning and regional development in Fujian Province.

Coupling coordination and influencing factors of urban spatial accessibility and economic spatial pattern in the New Western Land-Sea Corridor

The construction of the New Western Land-Sea Corridor is crucial to the economic development of western China and even Southeast Asia. Research analyzes the evolution of urban economic spatial pattern of the New Western Land-Sea Corridor in different years and discusses the coordinated development between economic connection and accessibility and its influencing factors. The research results show that: First, the influence of labor force on the urban centrality of the New Western Land-Sea Corridor is gradually increasing, and the spatial pattern of the urban network has gradually shifted from a unipolar attraction type to a spatial pattern of "one main and multiple subordinates." Second, urban accessibility presents a "core-periphery" spatial pattern, and the coupling coordination degree presents the spatial characteristics of "centro-periphery." The economic correlation strength, spatial accessibility, and the coordinated distribution of the two all have obvious spatial agglomeration characteristics. Third, there are spatial differences in the influencing factors of the coupling coordination degree. Based on this, the research puts forward the development mode of "growth pole," "area," and "axis," attaches importance to the problems of labor force in urban development, and strengthens the level of coupling coordination between regional transportation and economy, to promote the integration of regional transportation, logistics, and economy.

Coordinated development and driving factor heterogeneity of different types of urban agglomeration carbon emissions in China

Carbon emission (CE) reduction has become the primary task of China's urban agglomerations (UAs) in achieving sustainable development goals. This paper uses a decoupling model and coupling coordination model to measure the relationship between the development levels of different types of UAs and CEs in China from 2004 to 2016. Concurrently, the geographically and temporally weighted regression model is used to explore the spatial heterogeneity of the impact of different driving factors on the CEs of UAs. The results show the following: Most UAs have the potential to further decouple CEs and economic growth. Most UAs are still in coordinated development (> 0.5). Among the service innovation UAs, the Yangtze River Delta UA has a coupling coordination of less than 0.3, while the Pearl River Delta UA has a coupling coordination of more than 0.8, showing polarization. Manufacturing and resource-based UAs are still in the grinding adaptation stage (0.5-0.8). There are apparent spatiotemporal differences in the impacts of various driving factors on the CE of UAs. The level of land urbanization and investment in fixed assets promote CEs. However, the level of population urbanization and industrial structure restrain CEs. Therefore, reducing land development and industrial transformation can be an effective means to reduce CEs in UAs. These findings will provide extensive insights for different UAs to achieve differentiated low-carbon development.

Can the Spatial Function Division of Urbanization Promote Regional Coordinated Development? Evidence from the Yangtze River Economic Belt in China

The spatial function division of urbanization (SFDU) based on the value chain has an important impact on optimizing the industrial layouts of these areas and promoting regional coordinated development. Based on urban panel data from the Yangtze River Economic Belt (YREB) from 2007 to 2016, this paper uses the SYS-GMM, fixed-effects, and quantile regression methods to test the impact of the SFDU on regional coordinated development and further reveals its mechanism of impact. The results show the following: (1) the SFDU significantly improves the level of regional coordinated development, and the introduction of the SYS-GMM method enables us to overcome the endogenous problem of regression; (2) the improvement of capital allocation efficiency is an important way for the SFDU to promote regional coordinated development, whereas labor allocation efficiency is related to “process distortion”; (3) the impact of the SFDU on coordinated regional development in the middle and lower reaches of the YREB is stronger than that in the upper reaches; and (4) the promoting effect of the SFDU on coordinated regional development is significantly higher in the “economic coordination dimension” than in the “people’s livelihoods” and “ecological coordination” dimensions. This paper provides a valuable reference for the government to formulate regional coordinated development policies in basin economies around the world from the perspective of sustainable development.