Hand foot mouth disease (HFMD) is one of the widespread transmissible diseases that target preschool children, especially in urban regions in East Asia. Based on the mobile app data, a GIS automated regionalization method is used to define regions of various urbanicity levels. The variability of HFMD patients’ travel behaviors across these regions are examined by the complementary cumulative distribution functions (CCDFs). The travel burden in Nanchang increased as the patients’ residences moved toward regions of more rurality. Specifically, more urbanized regions near the city center (i.e., urban core and its surrounding urban) enjoyed better access to the healthcare service by spending an average of about 17-minute drive time. Patients residing in less urbanized regions such as suburbs and downtowns of surrounding rural counties either chose a nearby hospital or journeyed far to the region’s central Children’s Hospital, with average elevated travel time of 25 and 22 min, respectively. Those in rural areas travelled an average of 36 min, the longest among all regions. The study also finds a unique dual-peak pattern across two travel ranges in the study area due to the patients’ dilemma between pursuing high-quality hospitals and accommodating travel burden. Such a pattern mandates the adoption of a segmented regression approach to deriving the best-fitting CCDFs in most regions except for the rural.

中文翻译：

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南昌市不同城市水平区域手足口病就诊空间行为


手足口病 （HFMD） 是针对学龄前儿童的广泛传播疾病之一，尤其是在东亚城市地区。基于移动应用程序数据，使用 GIS 自动区域化方法来定义不同城市级别的区域。通过互补累积分布函数 （CCDF） 检查手足口病患者在这些地区的旅行行为的可变性。随着患者的住所向农村地区迁移，南昌的旅行负担也随之增加。具体来说，靠近市中心的城市化地区（即城市核心及其周边城市）平均花费约 17 分钟的车程，可以更好地获得医疗保健服务。居住在城市化程度较低地区（如周边农村县的郊区和市中心）的患者要么选择附近的医院，要么长途跋涉前往该地区的中心儿童医院，平均旅行时间分别为 25 分钟和 22 分钟。农村地区的人们平均出行时间为 36 分钟，是所有地区中最长的。该研究还发现，由于患者在追求高质量医院和适应旅行负担之间处于两难境地，研究区域的两个旅行范围存在独特的双峰模式。这种模式要求在除农村以外的大多数地区采用分段回归方法来推导出最佳拟合 CCDF。