Regional Disparities and Dynamic Changes in Practicing (Assistant) Physicians Resource Allocation Between Northern and Southern China

Regional Disparities and Dynamic Changes in Practicing (Assistant) Physicians Resource Allocation Between Northern and Southern China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Regional Disparities and Dynamic Changes in Practicing (Assistant) Physicians Resource Allocation Between Northern and Southern China Jiahao Zou, Yuexin Li, Hongyi Tan, Zhongqi Ji, Jinzhong Jia, Weiyan Jian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6801293/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 8 You are reading this latest preprint version Abstract Objective: This study aims to examine regional disparities and spatiotemporal dynamics in the allocation of Practicing (Assistant) Physicians between northern and southern China, using a north–south division that captures pronounced geographic and population heterogeneity. Methods: Based on data on Practicing (Assistant) Physicians from 31 provincial-level administrative regions in China from 2012 to 2022, this study analyzes regional differences and their dynamic evolution from three dimensions: total supply, per capita availability, and spatial accessibility. The number of Practicing (Assistant) Physicians per 1,000 population and the Health Resource Density Index (HRDI) were employed as key indicators. Results: From 2012 to 2022, the number of Practicing (Assistant) Physicians in southern China increased from 1.424 million (54.4%, 1.80 physicians per 1,000 population) to 2.511 million (56.6%, 2.99 physicians per 1,000 population), while the corresponding figures in northern China rose from 1.191 million (45.6%, 2.11 physicians per 1,000 population) to 1.924 million (43.4%, 3.39 physicians per 1,000 population). The growth rate of Practicing (Assistant) Physicians was notably higher in the southern region than in the northern region. In terms of allocation equity, the Gini coefficient between the northern and southern regions increased from 0.350 in 2012 to 0.373 in 2021. Within-region inequality exhibited divergent trends: the Gini coefficient in the northern region rose from 0.358 to 0.391, whereas that in the southern region declined from 0.327 to 0.311. Moreover, the Theil T index was significantly higher in the southern region, while the Theil L index was slightly higher in the northern region. Spatial autocorrelation analysis further revealed distinct spatial patterns across indicators. The distribution of Practicing (Assistant) Physicians per 1,000 population showed pronounced north–south clustering, with hotspot areas mainly located in northern China and cold spots concentrated in southern China. In contrast, the HRDI exhibited a clear east–west pattern, with hotspots clustered in eastern China and cold spots in western China. Conclusion: Southern China outperformed northern China in terms of the total number, growth rate, and HRDI of Practicing (Assistant) Physicians, with the interregional gap showing a widening trend over time; however, the southern region remained disadvantaged in terms of physicians per 1,000 population. Allocation disparities in southern China were more pronounced across provinces with different levels of economic development, whereas in northern China, inequities were primarily associated with variations in population density. The spatial distribution of Practicing (Assistant) Physicians in China showed distinct agglomeration patterns across different indicators. Both population equity and spatial accessibility must be considered, as a single indicator cannot fully reflect resource allocation situation. Targeted resource regulation strategies should be developed to address these varying dimensions. North-South Disparity Practicing (Assistant) Physicians Health Resources Density Index (HRDI) Spatial Autocorrelation Analysis Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 11 May, 2026 Reviews received at journal 10 May, 2026 Reviewers agreed at journal 30 Apr, 2026 Reviews received at journal 25 Apr, 2026 Reviewers agreed at journal 08 Apr, 2026 Reviewers invited by journal 07 Apr, 2026 Submission checks completed at journal 02 Mar, 2026 First submitted to journal 02 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6801293","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":619694643,"identity":"3dde16c2-d6c1-4119-89cf-86b84e23f7db","order_by":0,"name":"Jiahao Zou","email":"","orcid":"","institution":"Peking University","correspondingAuthor":false,"prefix":"","firstName":"Jiahao","middleName":"","lastName":"Zou","suffix":""},{"id":619694644,"identity":"b349556a-7ede-4ffe-ac12-f3d5ce81ef80","order_by":1,"name":"Yuexin Li","email":"","orcid":"","institution":"Shandong Institute of Parasitic Disease Prevention and 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AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"North-South Disparity, Practicing (Assistant) Physicians, Health Resources Density Index (HRDI), Spatial Autocorrelation Analysis","lastPublishedDoi":"10.21203/rs.3.rs-6801293/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6801293/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e This study aims to examine regional disparities and spatiotemporal dynamics in the allocation of Practicing (Assistant) Physicians between northern and southern China, using a north–south division that captures pronounced geographic and population heterogeneity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Based on data on Practicing (Assistant) Physicians from 31 provincial-level administrative regions in China from 2012 to 2022, this study analyzes regional differences and their dynamic evolution from three dimensions: total supply, per capita availability, and spatial accessibility. The number of Practicing (Assistant) Physicians per 1,000 population and the Health Resource Density Index (HRDI) were employed as key indicators.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eFrom 2012 to 2022, the number of Practicing (Assistant) Physicians in southern China increased from 1.424 million (54.4%, 1.80 physicians per 1,000 population) to 2.511 million (56.6%, 2.99 physicians per 1,000 population), while the corresponding figures in northern China rose from 1.191 million (45.6%, 2.11 physicians per 1,000 population) to 1.924 million (43.4%, 3.39 physicians per 1,000 population). The growth rate of Practicing (Assistant) Physicians was notably higher in the southern region than in the northern region. In terms of allocation equity, the Gini coefficient between the northern and southern regions increased from 0.350 in 2012 to 0.373 in 2021. Within-region inequality exhibited divergent trends: the Gini coefficient in the northern region rose from 0.358 to 0.391, whereas that in the southern region declined from 0.327 to 0.311. Moreover, the Theil T index was significantly higher in the southern region, while the Theil L index was slightly higher in the northern region. Spatial autocorrelation analysis further revealed distinct spatial patterns across indicators. The distribution of Practicing (Assistant) Physicians per 1,000 population showed pronounced north–south clustering, with hotspot areas mainly located in northern China and cold spots concentrated in southern China. In contrast, the HRDI exhibited a clear east–west pattern, with hotspots clustered in eastern China and cold spots in western China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Southern China outperformed northern China in terms of the total number, growth rate, and HRDI of Practicing (Assistant) Physicians, with the interregional gap showing a widening trend over time; however, the southern region remained disadvantaged in terms of physicians per 1,000 population. Allocation disparities in southern China were more pronounced across provinces with different levels of economic development, whereas in northern China, inequities were primarily associated with variations in population density. The spatial distribution of Practicing (Assistant) Physicians in China showed distinct agglomeration patterns across different indicators. Both population equity and spatial accessibility must be considered, as a single indicator cannot fully reflect resource allocation situation. Targeted resource regulation strategies should be developed to address these varying dimensions.\u003c/p\u003e","manuscriptTitle":"Regional Disparities and Dynamic Changes in Practicing (Assistant) Physicians Resource Allocation Between Northern and Southern China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-13 16:34:19","doi":"10.21203/rs.3.rs-6801293/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-11T07:48:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-11T02:14:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"128859012809556363558034219166694707370","date":"2026-04-30T06:36:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-25T14:12:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"306013463813702336373863986402235841874","date":"2026-04-08T13:24:07+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-07T13:15:09+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-03T04:36:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"Human Resources for Health","date":"2026-03-03T03:28:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"human-resources-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrhe","sideBox":"Learn more about [Human Resources for Health](http://human-resources-health.biomedcentral.com)","snPcode":"12960","submissionUrl":"https://submission.nature.com/new-submission/12960/3","title":"Human Resources for Health","twitterHandle":"@HRH_Journal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"dc6ba487-4532-44e5-ad79-5623652440c6","owner":[],"postedDate":"April 13th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-11T07:48:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-11T02:14:35+00:00","index":43,"fulltext":""},{"type":"reviewerAgreed","content":"128859012809556363558034219166694707370","date":"2026-04-30T06:36:32+00:00","index":42,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T07:57:35+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-13 16:34:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6801293","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6801293","identity":"rs-6801293","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}