The Characteristics of the Distribution of Healthcare Resources in Primary Healthcare Institutions between Provinces in China

Background Health care workers are vital service providers in primary healthcare, playing a crucial role in safeguarding public health, disease prevention, and chronic disease management. At present, research on healthcare resources mainly focuses on the quantity and structure, and there are few studies on the spatial distribution characteristics of healthcare resources. Objectives To analyze the spatial development trend of healthcare human resources in primary healthcare institutions nationwide, and to provide reference for optimizing the spatial allocation of healthcare resources and upgrading the level of primary healthcare services. Methods The data for this study were obtained during 2013-2017 China Health and Family Planning Statistical Yearbook, the 2018-2022 China Health and Wellness Statistical Yearbook, and the annual data of the National Bureau of Statistics (NBS) by province and the Ministry of Civil Affairs of China. From February to June 2023, the health density index (HRDI) was used to comprehensively reflect the demographic and geographic distribution of primary health care in China from 2012 to 2021, spatial autocorrelation analysis was applied to calculate the global Moran's I index to characterize the spatial distribution of primary health care resources in China from 2012 to 2021 analysis, and calculate the local Getis's G index to analyze the hotspots of primary care resource allocation in China from 2012 to 2021. Results The number of practicing physicians and nurses per 1 000 population at the grassroots level has increased in all regions of China, and the ratio of healthcare to nursing is still low. The high HRDI values for the number of practicing (assistant) physicians and nurses were in the eastern region, while the western region had lower HRDI values. The global Moran's I index for the number of practicing (assistant) physicians turned from negative to positive in 2016. The Moran's I index for nurses was always negative, but the overall trend was gradually approaching 0. Western regions such as Xinjiang and Xizang have low health density indices and are cold spots for resource distribution. Conclusion The allocation of medical and nursing resources to primary health care organizations has been increasing year by year, but there are obvious differences in allocation between provinces. The spatial correlation between physicians has gradually increased, and nurses have become more dispersed in their spatial distribution. It is recommended that the reserve of primary care physicians and nurses be strengthened, and that the ratio and collaboration between physicians and nurses be improved; that the planning of health care resources take into account both demographic and geographic configurations, and that Internet-based health care be promoted to improve the accessibility of health care services; and that the investment of resources in central and western China be increased, and that the construction of health care organizations be pushed forward in order to enhance the capacity of grass-roots-level services.