Will high-speed railway influence the healthcare seeking behaviour of patients? Quasi-experimental evidence from China

Health Policy Plan. 2021 Nov 11;36(10):1633-1643. doi: 10.1093/heapol/czab018.

Abstract

This study examines the impacts of high-speed railway (HSR) transportation on the healthcare-seeking behaviour of patients along newly integrated areas of Sichuan province, China. The opening of the Cheng-Mian-Le intercity HSR is considered as quasi-experimental evidence from China, and we make a propensity score matching the difference in differences research design, using data from the monthly report database of the Sichuan Province health statistical data collection and Decision Support System from 2014 to 2015. We find that, first, the opening of the HSR resulted in significant healthcare-seeking behaviour with great heterogeneity. Second, patients are more likely to go to areas with high-density healthcare resources, in which case HSR may mitigate the diagnostic inaccuracies that patients face locally. Third, the 'distance enhancement effect' was present, and its marginal effect is more significant for long-distance patients. Fourth, the tiered-network healthcare policy has no significant restrictive impact on patients seeking high-level medical services. Our results show that HSR establishment has a substantial impact on the behaviour of people seeking medical treatment and medicine. Furthermore, we discuss the results' policy implications for the allocation and integration of China's healthcare market, and the accessibility of medical and health services.

Keywords: China; High-speed railway; healthcare seeking; patients’; quasi-experiment; space-time contraction effect; tiered-network healthcare policy.

MeSH terms

  • China
  • Health Care Sector
  • Health Policy
  • Humans
  • Patient Acceptance of Health Care*
  • Transportation*