Study on regional disparities and influencing factors of public health service supply in China from the perspective of fairness.

Background: The public health service supply level is an essential factor affecting public health, and fairness is vital in distributing public health services. The spatiotemporal differences in public health services have attracted academic attention. However, few studies have systematically analyzed regional disparities and their influencing factors from a fair perspective. Therefore, this paper aims to explore the spatiotemporal distribution of public health service supply in China and its influencing factors from the standpoint of fairness.

Methods: First, based on the panel data of 31 provinces in China from 2010 to 2023, this paper constructs an objective evaluation index system for the supply level of public health services. Secondly, through the empirical analysis of the Dagum Gini coefficient, the temporal and spatial differences in the supply of public health services are explored. Regional disparities are analyzed from the perspective of fairness. Finally, the Tobit model is used to examine the impact of factors such as the proportion of the elderly population, the level of economic development, and demographic factors on the fairness of public health service supply.

Results: The study found that China's public health service supply has improved significantly since the new medical reform. However, there are still large differences between different regions, and the problem of unbalanced development within the region is prominent. The eastern coastal areas show a "polarization" trend, with hot spots and weak areas in public health service supply coexisting. Simultaneously, Tobit regression confirms that the deepening of aging and improving economic development significantly drive the supply of public health services.

Conclusions: The government should reasonably allocate public health resources according to the actual conditions of each region to achieve a "trickle-down effect." Especially in underdeveloped areas, the government should achieve fairness in service supply through precise policies. Concurrently, a cross-regional counterpart support mechanism should be established to promote soft power support, such as talent and technology. Medical and health services should be provided to the elderly and vulnerable groups through medical care and health industry models. Finally, relying on "Internet + medical health" to break down resource barriers and build a digital service platform covering the entire urban and rural areas to achieve fair distribution of public health resources and a "diffusion effect".