In China, upper-level healthcare (ULHC) and lower-level healthcare (LLHC) provide different public medical and health services. Only when these two levels of healthcare resources are distributed equally and synergistically can the public’s demands for healthcare be met fairly. Despite a number of previous studies having analysed the spatial distribution of healthcare and its determinants, few have evaluated the differences in spatial equity between ULHC and LLHC and investigated their institutional, geographical and socioeconomic influences and spillover effects. This study aims to bridge this gap by analysing panel data on the two levels of healthcare resources in 31 Chinese provinces covering the period 2003–2015 using Moran’s I models and dynamic spatial Durbin panel models (DSDMs). The results indicate that, over the study period, although both levels of healthcare resources improved considerably in all regions, spatial disparities were large. The spatio-temporal characteristics of ULHC and LLHC differed, although both levels were relatively low to the north-west of the Hu Huanyong Line. DSDM analysis revealed direct and indirect effects at both short-and long-term scales for both levels of healthcare resources. Meanwhile, the influencing factors had different impacts on the different levels of healthcare resources. In general, long-term effects were greater for ULHC and short-term effects were greater for LLHC. The spillover effects of ULHC were more significant than those of LLHC. More specifically, industrial structure, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of ULHC, while industrial structure, urbanisation, topography, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of LLHC. These findings have important implications for policymakers seeking to optimize the availability of the two levels of healthcare resources.

Enhancing the efficiency of public services is essential to residents in mountainous areas. It is also important to promote sustainable development of these regions. Analysing residents' satisfaction with public services in mountainous areas can help in evaluating outcomes of fiscal investment and identifying potential coping approaches for improving public service efficiencies. The residents' satisfaction with public services and the factors that influence such satisfaction were examined in this study. A study of 12 towns located in the southwestern Sichuan Province was performed using an entropy-weighted analytic hierarchy process (EWAHP), the technique for order preference by similarity to ideal solution (TOPSIS) and Tobit regression methods. The results indicate that: 1) the spatial distribution of satisfaction with public services is non-uniform, and the spatial distribution structure varies for different types of public services.2) Residents' satisfaction with public services is influenced by both objective and subjective factors. Population density, economic distance, social and cultural divisions and elevation are the major objective factors, whereas bounded rationality, the hierarchy of needs and service expectations are the main subjective factors. The most effective strategies for enhancing residents' satisfaction with public services are likely to be clustering the population, choosing supply centres with different public services, regulating the cultural division in ethnic minority towns, selecting supply priorities in accordance with residents' needs, implementing targeted intervention policies and establishing 'bottom-up' and 'top-down' integrated decision-making mechanisms.

Labor migration to urban centers is a common phenomenon in the Panxi region of the southwestern mountainous region of China, mainly owing to inadequate livelihood capital in rural areas. Numerous studies have been conducted to explore the relationship between labor migration and its causes, such as individual and family characteristics, but few studies have focused on livelihood capital. This paper examines the impact factors on labor migration employment location selection and duration from a household livelihood capital perspective. A case study of 279 households from 10 villages in the area was carried out in February 2016. We used both qualitative and quantitative methods to analyze the data. On the basis of the 279 questionnaires, the proportion of households with non-labor migration is 48.4%, whereas households with labor migration within a local city and migration across regions account for 28.7% and 22.9%, respectively. Social, financial, and human capitals are the primary factors that influence migrants' employment location choice positively. Among them, social capital has a significant impact on both migration within a local city and across regions; each of the regression coefficients is 1.111 and 1.183. Social, human, and financial capitals also have a positive impact on the duration of labor migration, and similarly, social capital is the highest coefficient with 2.489. However, physical capital only partly impacts labor migration across regions, whereas the impact of labor migration within a local city, and the duration, are not significant. Furthermore, the impact of household natural capital on migration space and time are all negative relationships, especially for labor migration across the regions and duration, with coefficient scores of 4.836 and 3.450, respectively. That is to say, a laborer is inclined to migrate within a local city for a short term, or not migrate at all, if natural capital is abundant. Our analysis results show that household livelihood capital has a strong spatio-temporal impact on labor migration.