Does the development of a high-speed railway improve the equalization of medical and health services? Evidence from China

Abstract

Does the development of a high-speed railway (HSR) have a significant impact on the equalization of medical and health resources allocated among cities? Based on the panel data of 67 cities in China from 2007 to 2016, this paper investigates the direct and dynamic effects of HSR development on the equalization of medical and health services by using the difference-in-differences (DID) method. The empirical results show that an HSR connection significantly reduces the equalization level of medical and health services in cities and that the effect is larger for the period from the year of the connection to the second year. However, in the long term, HSR development improves the equalization level of medical and health services in cities. Heterogeneity tests show that the effect of the HSR connection shows an “N”-shaped trend under different city scales, the equalization level of medical resources in the largest cities benefit the most from HSR development, and the Eastern and Western regions of China are more sensitive to the HSR connection. While the allocation of medical resources is in the direction of equalization, the level of medical resources is significantly more equal with the HSR development in cities with stronger financial capacity and non-core cities. The analysis of other city characteristics provides policy recommendations for improving the public services delivery mode in China’s heterogeneous cities in terms of HSR development.