Travel Behaviors of Hand-Foot-and-Mouth Disease Patients Across Hospital Service Areas in Nanchang City, China

This paper examines the travel behaviors of hand-foot-and-mouth disease (HFMD) patients in Nanchang City in central China. Based on the HFMD patients’ hospital visitation data from the Center of Disease Control (CDC) of Nanchang in 2018, a spatial network of patient-to-hospital trip flows is constructed. A Geographic Information Systems (GIS) automated network community detection method, termed ‘ScLeiden’, is utilized to delineate the study area into six hospital service areas (HSAs) to represent distinctive health care markets. Patients’ travel patterns across these HSAs are compared to highlight the geographic disparity. In two HSAs anchored by major hospitals in the regions, the volume of patients increased up to a travel range and then declined, and thus formed a single peak in the trip volume distribution curve across travel time. Each of the remaining four HSAs exhibited two or more peaks in their trip volume distribution curves. The patterns reflected the split choices of patients for the largest Children Hospital in the region, the second-tier county hospital, or others, which were likely to be stratified by their economic affordability, transportation means, and possible health literacy. The study provides valuable insights into the delineation of HSAs and the unique patients’ travel behaviors in China.