Urban and Rural Population and Development Research on Medical Coordination: In View of Dalian 2008-2017 Official Statistics.

Providing universal quality health services is one of the Sustainable Development Goals (SDG) to achieve by 2030. We evaluated the sustainable and coordinated development of urban and rural medical care from 2008-2017 in Dalian, China, by developing an evaluation system based on population and health services. We used a comprehensive development index model and a coupling coordination model to evaluate the status and sustainable development of population and medical services in Dalian. The overall level of population development index in urban areas was significantly lower than in rural areas in the past decade. Comparing the data for 2008 and 2017, Zhongshan District (-31.51%), Ganjingzi District (-25.67%), Lyshunkou District (-35.45%), and Pulandian District (-19.59%) posted significant declines in the population development index. The overall medical service development index for both urban and rural areas registered a steady upward trend. In terms of the relationship between population and medical services, a more pronounced coupling running-in stage was observed among urban areas than among rural areas. Among urban areas, the coupling running-in stage in Zhongshan District (2013-2016) and Shahekou District (2011-2014) was most pronounced, while among rural areas, Jinzhou District (2012-2016, 0.684~0.756) had the most distinct coupling running-in stage. In terms of coordination development, we found that both urban and rural areas experienced a long period of moderate coordination stage. Among urban areas, except for some middle and mountainous districts with unstable changes in the coordination degree, the overall development trend in the region showed a stable transition from moderate coordination stage towards high coordination stage. From 2008 to 2017, only the coordination degree in Jinzhou District (-9.17%) showed negative growth. Although considerable efforts have been initiated to improve the coordinated development of Dalian's urban and rural populations and its medical services, the medical and healthcare systems still face numerous challenges.

Examining the Urban and Rural Healthcare Progress in Big Cities of China: Analysis of Monitoring Data in Dalian from 2008 to 2017.

How to effectively reduce the disparity between urban and rural medical healthcare has become a major global concern. In China, the government has issued a series of reform measures to address the gap between urban and rural medical care. To explore the impact of China's medical system reforms in improving health services in urban and rural areas and understand the factors promoting and hindering progress, we evaluated the healthcare system in Dalian City, China, from 2008 to 2017. The weighted TOPSIS (technique for order preference by similarity to ideal solution) model was used to assess the development of the healthcare system in the different districts and employed the obstacle model to identify and analyze indicators that hinder progress in health services. Using the local spatial clustering function, we categorized the districts in terms of the hindrance type that significantly hamper the growth of the healthcare system. Our results show the healthcare system in Dalian's urban areas has steadily increased, while development in rural areas has been erratic. Although the urban-rural healthcare disparity has narrowed distinctly, sustained progress is not guaranteed. Based on the location theory, residents in urban areas are more affected by economic factors, while those in rural areas are more influenced by time considerations. When initiating healthcare reforms in urban areas, the impact of varying land prices and per capita disposable income should be considered. For rural areas, constructing more medical institutions to reduce the impact of time costs should be considered. We also found different factors that hinder the growth of the healthcare system for urban and rural areas. To address these impediments to progress, urban areas should pay more attention to coordinated development, while rural areas should address specific concerns based on local needs and conditions. More research on the progress in medical reform is crucial to provide reference and policy-guidance for countries facing similar concerns.