Study on Fractal Characteristics of Migration-Population Flow—Evidence from Egypt

The influence of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in Chinese low-income areas

BACKGROUND

In recent years, due to the increasing number of cross-regional medical patients, countries around the world have issued a series of policies or regulations to reduce their out-of-pocket burden. In this context, this study intended to explore the impact of the Spatio-temporal characteristics of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in low-income areas.

METHODS

This study included 54,904 data of cross-provincial medical treatment of malignant tumor patients insured in Heilongjiang Province, China in 2020. Firstly, Microsoft Excel 2019 and ArcGIS 10.2 were applied to conduct a descriptive analysis of the Spatio-temporal characteristics of their cross-provincial medical treatment. Then, binary and multivariate logistic regression models were used to explore the specific impact of economic level and geographical distance of medical regions on total medical expenses, medical insurance payments, and out-of-pocket expenses.

RESULTS

The number of cross-regional medical patients showed a gradual upward trend from February to December, and fell back in January. They were concentrated in regions with high economic level and short distance from the insured region, where were more likely to form the group with high out-of-pocket expenses (AOR = 3.620, P < 0.001; AOR = 1.882, P < 0.001). While this possibility in middle-distance medical regions were less (AOR = 0.545, P < 0.001). Afterwards, two sensitivity analysis methods showed that the results were robust.

CONCLUSION

The number of cross-regional medical patients with malignant tumors in low-income areas is affected by seasonal factors, meanwhile, their total medical expenses, actual medical insurance payment levels, and out-of-pocket expenses are all affected by the economic level and geographical distance of medical regions. And the middle-distance medical regions may be the best choice for patients with planned cross-regional medical treatment. These provide some evidence for policymakers to improve the fairness and sustainability of medical security for cross-regional medical patients and reduce their direct economic burden of disease.

Spatial and temporal distribution of population in urban agglomerations changes in China

The spatial distribution of the urban agglomeration population has changed increasingly in rapid urbanization. It affects the urban economy, environment, transportation, and so on. Therefore, it is of great significance to understand the changes in the spatial distribution of population in urban agglomerations. This study used methods such as population center of gravity migration and Gini coefficient to explore changes in the spatial distribution of urban populations. The study found that the population center of the Beijing-Tianjin-Hebei urban agglomeration first migrated toward Beijing and then away from Beijing. During this process, the Gini coefficient increased from 0.62 to 0.64 and then decreased to 0.58, indicating that the population balance of the urban agglomeration firstly increased and then decreased. This result is consistent with the conclusion that we have established a simulated urban agglomeration for theoretical derivation. That is: in the early stage of urban agglomeration development, the population migrated to the central city; as the population of the central city became saturated, the urban agglomeration developed to a mature stage, and the population began to migrate to the peripheral cities. In this process, the population distribution center of urban agglomeration gradually shifted from central towns to peripheral towns. The degree of equilibrium in the spatial distribution of population has undergone an inverted u-shaped transition from non-equilibrium to equilibrium.

Geographic Complexity: Concepts, Theories, and Practices

Geography is a fundamentally important discipline that provides a framework for understanding the complex surface of our Earth [...]

Spatial Patterns and Driving Factors of Rural Population Loss under Urban–Rural Integration Development: A Micro-Scale Study on the Village Level in a Hilly Region

Under the background of urban–rural integration, balanced development between urban and rural areas has been increasingly advocated. Rural population loss (RPL) is not only due to the laws of social and economic development but also the comprehensive action of natural, social, and economic factors. Taking 774 administrative villages in Laiyang County, which is in a hilly region, as our research area, we comprehensively used spatial analysis and geographic detectors to explore the spatial characteristics and driving factors of RPL, which was significantly correlated with rural planning. The research demonstrated that: (1) The rural population in Laiyang County generally had a low level of RPL (1.9%), but each village varied greatly. The village with the greatest RPL had a rate of 56%. The RPL between urban and rural areas, towns and streets, and villages and villages were unbalanced, and rural population flow mainly occurred between urban and rural areas. (2) RPL in Laiyang County was generally low in the central urban area and high in the northern and southern areas. Population loss presents agglomeration globally and high–low agglomeration locally. (3) The distance from village to county, elevation, cultivated land quantity, collective economic income, village area, and ecological service value were the key factors influencing RPL in Laiyang County. When comparing the dominant factors, the interaction between collective income and elevation was the strongest. Exploring the spatial characteristics and influencing factors of RPL provided us with ideas for the classified promotion of rural revitalization, preparation of rural development planning, and promotion of the integrated development of urban and rural areas.