Abstract Hospital bypass behaviour, where patients forgo nearby hospitals for distant providers, challenges the efficiency of healthcare systems. However, its socioeconomic status (SES) drivers and equity implications remain poorly understood. Here we analyse 96 million mobile phone users across 11 Chinese cities integrated with behavioural models quantifying the trade-off between spatial proximity and hospital quality. Results show 80.63% of patients bypass their nearest hospital with 211.84% increased travel distance. Low-SES patients exhibit paradoxical bypass patterns with 14.01% lower bypass rate but stronger bypass intensity (skip 8.02% more hospitals) than high-SES patients. Behavioural modelling reveals that low-SES patients have 5.9-fold stronger willingness to travel for hospital quality. Their intense travel burden represents a compensatory mechanism to overcome spatial quality deficits, and this preference-driven spatial sorting unintentionally reduces 42.15% experienced social segregation within hospitals. Our findings highlight the need to address the structural spatial mismatch in medical quality rather than relying on geographic proximity or access restrictions only.
Xia et al. (Fri,) studied this question.