Spatial heterogeneity of health care resources: a study of the socioeconomic, demographic, and natural geographic conditions of ethnic minority regions in Southwestern China

The inequitable distribution of health care resources causes disparities in access to health care services, impacting residents’ health status and quality of life. As a result, the allocation of health care resources has become a critical concern for governments when health care policies are formulated. China is a developing country with uneven development among cities and rural areas; thus, the problem of inequity in health care resources is noticeable, especially in less developed areas. Hence, we aimed to explore the spatial distribution of the average number of physicians and hospital beds in Guangxi and used spatial models to analyse the effects of economic, demographic and elevation factors on the distribution of health care resources. These findings may provide a basis for the government to improve health policies. We described the spatial patterns of the number of hospitals (NH), the number of hospital beds per 10,000 people (NHB), and the number of practising physicians per 10,000 people (NPP) in Guangxi. Afterwards, we explored the economic and demographic factors that may influence the spatial distribution of the NHB and NPP through geographically weighted regression ( GWR) and multiscale geographically weighted regression (MGWR) models. Guangxi’s NH (Moran's I = 0.127, p = 0.006), NHB (Moran's I = 1.363, p = 0.001), and NPP (Moran's I = 1.289, p < 0.001) exhibited significant autocorrelation and heterogeneity in terms of spatial distribution, significantly clustering and forming hotspots in Nanning, Liuzhou, Guilin, and Wuzhou. Spatial regression of the NHB with the proportion of the population ≥ 60 years old (beta = 0.337, p = 0.001), average years of schooling (beta = 0.409, p = 0.002), general government revenue (beta = 0.228, p = 0.023), and average elevation (beta = 0.225, p = 0.042) was performed, where NPP was related to population density (beta = 0.230, p = 0.009), the proportion of the population ≥ 60 years old (beta = 0.250, p = 0.003), and gross social consumption (beta = 0.241, p = 0.010). There were significant spatial regression relationships between gross domestic product per capita (beta = 0.324, p < 0.001) and the percentage of urban residents (beta = 0.172, p = 0.033). The spatial heterogeneity of health care resources in Guangxi is related to the unqual socioeconomic, cultural, and population development and is influenced by topographical factors. In Guangxi, health care resources are clustered in areas with a relatively good degree of social development, such as Nanning, Liuzhou, Guilin, and Wuzhou, with both absolute and relative deficiencies and with different factors influencing the number of beds per capita and the number of physicians per capita. Moreover, feasible ways to meet the demand for health care resources in different regions should be explored.