Study Analyzes Pediatric Major Illness Patterns and Healthcare Disparities Across China

An investigation of 13,112 platform-reported pediatric major-disease cases across mainland China identified pronounced multi-scale spatial variation, marked by higher population-normalized case measures in northeastern and eastern regions and comparatively lower values in western provinces. Global Moran’s I statistics demonstrated statistically significant positive spatial autocorrelation across all six evaluated major disease categories, while Getis–Ord Gi* spatial statistics identified distinct, statistically significant spatial hot spots and cold spots across the country.

The observational study, published in the International Journal for Equity in Health, evaluated publicly disclosed platform records across 31 provincial-level administrative units in mainland China. The analyzed cohort comprised individuals aged 18 years or younger categorized into six major diagnostic classifications: solid tumors, hematological diseases, metabolic diseases, rare and genetic diseases, trauma and surgical conditions, and organ failure and sequelae. Spatial comparisons were conducted by calculating cumulative platform-reported case rates per 100,000 resident minors.

Age-specific analyses across five developmental stages revealed distinct diagnostic distributions across early life and childhood. Solid tumors along with rare and genetic diseases constituted comparatively larger proportions of platform-reported cases during early developmental periods, whereas hematological conditions and metabolic disorders were more heavily concentrated in childhood age brackets. Spatial heterogeneity was evaluated at both provincial and seven-region territorial scales to assess regional patterns.

To examine environmental, socioeconomic, and healthcare-associated factors, researchers implemented GeoDetector exploratory analysis employing four strata alongside permutation tests and sensitivity assessments. Total population size, environmental pollution levels, and healthcare resource measures exhibited comparatively high spatial explanatory power for several pediatric disease categories. In addition, specific factor pairings demonstrated enhanced joint spatial explanatory power in explaining the observed disease distribution patterns.

Healthcare utilization patterns showed substantial geographic centralization, with 33.16 percent of the reported pediatric cases (4,348 patients; 95% CI: 32.36–33.97%) seeking treatment outside their province of registered residence. Of these cross-provincial patient movements, 67.89 percent were directed toward Beijing, Shanghai, and Guangdong. A population-weighted Theil index decomposition demonstrated that inequalities in healthcare resources varied by resource type, showing divergent relative contributions of between-region and within-region inequalities across healthcare personnel, healthcare institutions, and hospital beds, providing descriptive baseline evidence for regional pediatric healthcare resource planning.

Subject of Research: Geographic distribution of pediatric major-disease cases and healthcare resource inequality in China

Article Title: Geographic patterns of platform-reported pediatric major-disease cases and healthcare inequality in China: spatial associations and cross-regional healthcare seeking

Article References: Li, H., Cao, Y., Li, S., Zhao, Y., & Li, F. (2026). Geographic patterns of platform-reported pediatric major-disease cases and healthcare inequality in China: spatial associations and cross-regional healthcare seeking. International Journal for Equity in Health. https://doi.org/10.1186/s12939-026-03109-1

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03109-1

Keywords: pediatric healthcare, spatial epidemiology, healthcare inequality, cross-regional healthcare seeking, China, Theil index, solid tumors, rare diseases, Geographic, patterns, platform-reported, pediatric