{
  "abstract": "Introduction: Territorial health equity depends not only on expanding health resources but also on aligning local capacity with territorial planning contexts. We examined whether changes in hospital and health-center bed allocation were associated more strongly with territorial planning context or local fiscal-economic capacity.\n\nMethods: We analyzed a 2015-2023 panel of 1,787 geometry-stable non-district counties in China. The analysis combined county and province-by-year fixed effects, long-difference models, block-level Shapley decomposition, high-mismatch-state transitions, spatial diagnostics, discrete-time exit models, and adjacent-county pair comparisons.\n\nResults: Median beds per 10,000 registered residents increased from 35.1 in 2015 to 54.0 in 2023, whereas the distribution of relative planning-supply mismatch changed little. Planning-context and capacity blocks explained similarly small shares of annual variation in total beds. For bed density, the larger baseline planning-context share was driven primarily by the negative population coefficient and did not indicate allocation aligned with observed healthcare need. Higher initial capacity was associated with greater cumulative bed-density growth, lower relative mismatch, and a higher probability of exiting the high-mismatch state. Among county-years previously classified as high-mismatch, 84.0% remained in that state in the following year. Relative mismatch remained spatially clustered, but prefecture boundaries did not significantly amplify capacity-related bed-density gaps.\n\nDiscussion: Aggregate expansion, relative territorial alignment, and recovery from persistent high mismatch represent distinct health-system outcomes. The findings support context-sensitive allocation, capacity-sensitive financing, and duration-sensitive monitoring, while remaining associational rather than causal.",
  "abstract_shown": true,
  "affiliations": [
    "School of Law, Central China Normal University",
    "School of Marxism, Sichuan Agricultural University",
    "Institute of Medical Information & Library, Chinese Academy of Medical Sciences and Peking Union Medical College",
    "College of Law, Sichuan Agricultural University"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Kai Dai"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Ziao Chen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ling Wang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Zihao Lin"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yiqiang Feng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8n742kkek0zjv.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1970301",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13719399/?tool=EBI",
  "id": "8n742kkek0zjv",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1970301/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2003|Healthcare Systems and Reforms"
    ]
  ],
  "openalex": "W7222685558",
  "pdf_url": "https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1970301/pdf",
  "pmcid": "PMC13719399",
  "pmid": "42964154",
  "published": "2026-10-16",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/8n742kkek0zjv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "10.3389/fpubh.2026.1970301",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1970301/full"
    },
    {
      "first_seen": "2026-10-31T12:21:36Z",
      "native_id": "PMC:PMC13719399",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13719399"
    },
    {
      "first_seen": "2026-11-02T12:23:22Z",
      "native_id": "PMC13719399",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpubh.2026.1970301"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2296-2565",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Hospital and health-center bed expansion and persistent relative mismatch across geometry-stable non-district Chinese counties, 2015–2023",
  "title_text": "Hospital and health-center bed expansion and persistent relative mismatch across geometry-stable non-district Chinese counties, 2015–2023",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:20:28Z",
  "url": "https://research.draconitic.com/paper/8n742kkek0zjv",
  "venue": "Frontiers in Public Health",
  "versions": []
}