Identifying determinants of spatial agglomeration of healthcare resources by using spatial econometric methods: a longitudinal study in China.

Background: Healthcare resources are necessary for individuals to maintain their health. The Chinese government has implemented policies to optimize the allocation of healthcare resources and achieve the goal of equality in healthcare for the Chinese people since the implementation of the new medical reform in 2009. Given that no study has investigated regional differences from the perspective of healthcare resource agglomeration, this study aimed to investigate China's healthcare agglomeration from 2009 to 2017 in China and identify its determinants to provide theoretical evidence for the government to develop and implement scientific and rational healthcare policies. Methods: The study was conducted using 2009-2017 data to analyze health-resource agglomeration on institutions, beds, and workforce in China. An agglomeration index was applied to evaluate the degree of regional differences in healthcare resource allocation, and spatial econometric models were constructed to identify determinants of the spatial agglomeration of healthcare resources. Results: From 2009 to 2017, all the agglomeration indexes of healthcare exhibited a downward trend except for the number of institutions in China. Population density (PD), government health expenditures (GHE), urban resident's disposable income (URDI), geographical location (GL), and urbanization level (UL) all had positive significant effects on the agglomeration of beds, whereas both per capita health expenditures (PCHE), number of college students (NCS), and maternal mortality rate (MMR) had significant negative effects on the agglomeration of institutions, beds, and the workforce. In addition, population density (PD) and per capita gross domestic product (PCGDP) in one province had negative spatial spillover effects on the agglomeration of beds and the workforce in neighboring provinces. However, MMR had a positive spatial spillover effect on the agglomeration of beds and the workforce in those regions. Conclusion: The agglomeration of healthcare resources was observed to remain at an ideal level in China from 2009 to 2017. According to the significant determinants, some corresponding targeted measures for the Chinese government and other developing countries should be fully developed to balance regional disparities in the agglomeration of healthcare resources across administrative regions.

Evaluation of the Medical Resource Allocation: Evidence from China.

Medical resource allocation is an increasingly crucial issue. It is vital to understand residents' (people living in the local area) evaluation of it. This study explores residents' evaluation of medical resource allocation and its determinants with the dimensions of medical resource adequacy, balance, publicness, and accessibility. We used data from the China General Social Survey (CGSS). Binary logistic regression models were constructed from the four dimensions separately, and we compared the differences among them. The study's results showed that accessibility and publicness are the highest and lowest dimensions of residents' evaluation, respectively. The high evaluation of social equity may be a positive contributor to a higher evaluation of publicness and accessibility. The central region residents had the lowest evaluation of adequacy (OR = 0.697, p = 0.010) and balance (OR = 0.642, p = 0.008). To sum up, perceived social equity, social trust, and social class are crucial factors. Based on the results, the government should strengthen the supervision of the medical market, increase financial support for the health field in the central region, and establish a multi-level medical security system that may help optimize the allocation.

A 4-year longitudinal study examining lexical and syntactic bootstrapping in English Language Learners (ELLs) and their monolingual peers.

Current models of the affinity between syntax and vocabulary are complex and recognize the contribution of bootstrapping and computational processes. To date, the mutual facilitation between these two constructs over time has not been studied in second language (L2) school children. The present study investigated longitudinally the direction and strength of the associations between syntactic and vocabulary skills in English Language Learners (ELLs; N = 409, 204 females, M age = 78 months, low socioeconomic status backgrounds) and their monolingual English-speaking peers (EL1; N = 157, 92 females, M age = 77 months, low socioeconomic status backgrounds). Children were assessed annually from Grade 1 to Grade 4 on a syntactic and a vocabulary task. Overall, autoregressive cross-lagged analyses indicated that early syntax predicted later vocabulary and vice versa, yet, the magnitude of prediction varied across groups. Notably, in the early stages of L2 learning, the predictive power from vocabulary to syntax was stronger than that in the opposite direction. Moreover, the predictive power from vocabulary to syntax was consistently stronger in the ELL than in the EL1 group. The results suggest that, in general, with sufficient quantity and quality of exposure to the L2, lexical and syntactic bootstrapping coexist. However, among novice young ELLs, bootstrapping is stronger from vocabulary to syntax than the other way around. Results underscore the importance of studying the relations between vocabulary and syntax longitudinally, and caution about an injudicious application of L1-based models to young L2 children's language development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).