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Outline
To classify cross-district/county medical visits into upward flow (from low-GDP districts to high-GDP districts) and downward flow (from high-GDP districts to low-GDP districts), analyze their influencing factors and differences from overall cross-district/county visits, and provide theoretical support for optimal allocation of medical resources.
Data were obtained from the front pages of medical records of inpatients in Sichuan Province in 2022. Taking inpatients as the study subjects, two types of cross-district/county medical visits were classified. Geographic information software was used for spatial visualization, and a two-level random intercept logistic regression model was applied to analyze influencing factors from patient, institutional and regional dimensions.
In 2022, the proportion of cross-district/county hospitalization in Sichuan was 29.20%, including 23.37% upward flow and 5.83% downward flow. Maintenance chemotherapy for malignant tumors accounted for the highest proportion in overall (4.97%) and upward flow (6.67%), while schizophrenia (2.69%) ranked first in downward flow. West China Hospital of Sichuan University in Wuhou District was the top choice for overall (5.69%) and upward flow (7.10%), and Chengdu Second People’s Hospital in Jinjiang District was preferred for downward flow (7.92%). The effects of occupation type, medical insurance and other individual factors became more significant after distinguishing the two flows.
Upward and downward cross-district/county medical visits showed distinct demand differences: the former pursues high-quality medical services, while the latter mainly focuses on rehabilitation and other needs. Local governments should strengthen specialized or primary care services based on patient outflow and resource conditions, improve the rate of seeking care within the county, and promote the efficient, fair and sustainable development of the medical service system.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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