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Background <p>Understanding the supply-demand relationship of medical services is essential for regional planning. Existing city-scale studies typically exclude cross-city flows, whereas national-scale studies often overlook intra-city heterogeneity. In urban agglomerations, healthcare resources and transport infrastructure are usually planned by cities, although patients may cross city boundaries to seek care. The implications of cross-city trips for regional medical services remain insufficiently understood. Taking the Pearl River Delta as a case, this study investigates cross-city hospital visiting trips and their implications for medical service evaluation.</p> Methods <p>Using 91.2&#xa0;million automobile navigation records collected in 2019, 1.37&#xa0;million hospital visiting trips to Grade 3 hospitals were identified through a modified spatial join method. A population–hospital bipartite network and a multi-scale analytical framework were constructed. Cross-city demand and supply indices were developed at the city, subdistrict, and hospital scales to characterize cross-city medical service patterns and influencing factors. Accessibility and Gini coefficients were computed under intra-city and regional evaluation scenarios to assess how incorporating cross-city hospital visiting trips affects medical service evaluation.</p> Results <p>Based on automobile navigation data, 9.1% of identified hospital visiting trips crossed city boundaries. Guangzhou and Shenzhen served as dominant regional suppliers, with cross-city supply indices of 55.9% and 21.8%, respectively. Cross-city demand was negatively associated with distance to boundary, GDP per capita, and hospital beds. Cross-city service share was negatively associated with distance to boundary, whereas contributions to regional cross-city service provision were positively associated with hospital size and hospital grade. Incorporating cross-city flows increased accessibility in most peripheral areas and reduced the regional population-weighted Gini coefficient from 0.596 to 0.522.</p> Conclusions <p>Based on automobile navigation data, cross-city hospital visiting trips constitute an important component of medical service utilization in urban agglomerations. At the subdistrict scale, cross-city demand was jointly associated with boundary proximity and local economic and medical conditions. At the hospital scale, the cross-city service share was higher among hospitals closer to city boundaries, whereas contributions to regional cross-city medical service provision were greater among larger and higher-grade hospitals. Evaluation frameworks relying solely on intra-city data tend to underestimate accessibility in boundary areas and, in most cases, overestimate the Gini coefficient.</p>

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Exploring cross-city hospital visiting trips for medical service evaluation in urban agglomeration areas based on automobile navigation data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月8日

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  • Xi Yu,
  • Zhengdong Huang,
  • Renzhong Guo,
  • Jizhe Xia,
  • Sa Ma

摘要

Background

Understanding the supply-demand relationship of medical services is essential for regional planning. Existing city-scale studies typically exclude cross-city flows, whereas national-scale studies often overlook intra-city heterogeneity. In urban agglomerations, healthcare resources and transport infrastructure are usually planned by cities, although patients may cross city boundaries to seek care. The implications of cross-city trips for regional medical services remain insufficiently understood. Taking the Pearl River Delta as a case, this study investigates cross-city hospital visiting trips and their implications for medical service evaluation.

Methods

Using 91.2 million automobile navigation records collected in 2019, 1.37 million hospital visiting trips to Grade 3 hospitals were identified through a modified spatial join method. A population–hospital bipartite network and a multi-scale analytical framework were constructed. Cross-city demand and supply indices were developed at the city, subdistrict, and hospital scales to characterize cross-city medical service patterns and influencing factors. Accessibility and Gini coefficients were computed under intra-city and regional evaluation scenarios to assess how incorporating cross-city hospital visiting trips affects medical service evaluation.

Results

Based on automobile navigation data, 9.1% of identified hospital visiting trips crossed city boundaries. Guangzhou and Shenzhen served as dominant regional suppliers, with cross-city supply indices of 55.9% and 21.8%, respectively. Cross-city demand was negatively associated with distance to boundary, GDP per capita, and hospital beds. Cross-city service share was negatively associated with distance to boundary, whereas contributions to regional cross-city service provision were positively associated with hospital size and hospital grade. Incorporating cross-city flows increased accessibility in most peripheral areas and reduced the regional population-weighted Gini coefficient from 0.596 to 0.522.

Conclusions

Based on automobile navigation data, cross-city hospital visiting trips constitute an important component of medical service utilization in urban agglomerations. At the subdistrict scale, cross-city demand was jointly associated with boundary proximity and local economic and medical conditions. At the hospital scale, the cross-city service share was higher among hospitals closer to city boundaries, whereas contributions to regional cross-city medical service provision were greater among larger and higher-grade hospitals. Evaluation frameworks relying solely on intra-city data tend to underestimate accessibility in boundary areas and, in most cases, overestimate the Gini coefficient.