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Background Even though China launched a series of measures to alleviate several financial burdens (including health insurance scheme, increased government investment, and so on), the economic burden of health expenditure has still not been alleviated. Out-of-pocket payments (OPPs) show not only a time correlation but also some degree of spatial correlation. The aims of the current study were thus to identify the spatial cluster of OPPs, to investigate the main factors affecting variation, and to explore the spatial spillover sources of China’s OPP. Methods Global and local spatial autocorrelation tests were validated to identify the spatial cluster of OPPs using the panel data of 31 provinces in China from 2005 to 2016. The Spatial Durbin Model, established in this paper, measured the spatial spillover effect of OPPs and analyzed the possible spillover sources (demand, supply, and socio-economic factors. Results OPPs were found to have a significant and positive spatial correlation. The results of the Spatial Durbin Model showed the direct and indirect effects of demand, supply, and socio- economic factors on China’s OPPs. Among the demand factors, the direct and indirect correlation (elasticity) coefficients were positive. Among the supply factors, the direct and indirect effects of the share of primary health beds on residents’ OPPs were negative. The ratio of health technicians in hospitals to those in primary health institutions on per capital OPPs had a significant indirect effect. Among the socio-economic factors, the direct effects of GDP, government health expenditure, and urbanization on OPPs were found to be positive. There were no significant indirect effects of socio-economic factors on OPPs. Conclusion This paper finds that China’s OPPs are not randomly distributed but, overall, present a positive spatial cluster, even though a series of measures have been launched to promote health equity. Socio-economic factors and those associated with demand were found to be the main influences of variation in OPPs, while demand was seen to be the driver of the positive spatial spillover of OPPs, whereby effective supply could inhibit these positive spillover effects. Electronic supplementary material The online version of this article (10.1186/s12913-019-4451-0) contains supplementary material, which is available to authorized users.

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Ilicis rotundae Cortex (IRC, also called Jiubiying) is a traditional Chinese medicine, factors such as the origin and growing environments will affect its quality and content of active ingredients. Therefore, it is necessary to realize rapid detection to better implement quality control. Raman spectroscopy has been commonly used to identify molecules and analyse biological compounds in Fingerprints. In this study, four commercial samples from different origins were collected, Raman spectra of four samples were established by confocal Raman microscopy at 785 nm, and the positions and attribution of spectral peaks were determined. The similarity of spectra were analyzed by MATLAB software, and the first and second derivative were transformed to establish the characteristic fingerprints. In the results, all the samples showed common characteristic peaks near 448, 481, 565, 868, 944 and 1088 cm−1, showing the spectral characteristics of carbohydrates and glycosidic bonds. The correlation coefficient of the characteristic peaks of the samples were between 0.9745 and 0.9951, and the consistency coefficient were between 0.9782 and 0.9944. The peak shapes of the first derivative of spectrum were significantly different among the range of 180–340, 460–540, 700–860 and 1010–1100 cm−1, and the peak shapes of the second derivative of spectrum were significantly different among the range of 180–340, 500–540 and 760–860 cm−1. In conclusion, the first and second derivative of Raman spectra for samples from four different sources were significantly different, indicating the Raman fingerprint was successfully established, which can be used as a basis for rapid identification of IRC decoction pieces which lays a foundation for the further identification of decoction pieces from different origins.