Urbanization and Hospital Accessibility Inequality in China: Evidence from 2020 Provincial Data

Background Achieving equitable hospital access is a recognized global imperative for UHC and SDG 3; China has made significant progress in public health investment, yet persistent regional disparities remain a structural impediment to realizing the 'Healthy China 2030' goals. Methods The analysis was constructed using provincial-level data from 2020, integrating indicators of hospital accessibility inequality (the population-weighted Gini index), GDP per capita (USD), the proportion of the population aged 65 and above, and the urbanization rate. Ordinary Least Squares (OLS) models were estimated, reporting both conventional and robust standard errors. This quantitative analysis was further supplemented by scatter plots. Results Hospital accessibility inequality demonstrated significant inter-provincial variation. Our primary finding indicates that the urbanization rate was significantly negatively associated with this inequality (β=−0.0073). Conversely, neither GDP per capita nor the aging population proportion were found to be significant predictors. These core results were robustly confirmed by subsequent checks. Conclusion Urbanization emerges as a significant determinant of hospital accessibility equity in China. The findings suggest that achieving national health equity goals necessitates policy interventions that foster balanced urban–rural development, alongside targeted initiatives to strengthen transportation networks and enhance healthcare infrastructure specifically within underserved and less-developed regions.