Health care workers are vital service providers in primary healthcare, playing a crucial role in safeguarding public health, disease prevention, and chronic disease management. At present, research on healthcare resources mainly focuses on the quantity and structure, and there are few studies on the spatial distribution characteristics of healthcare resources.

To analyze the spatial development trend of healthcare human resources in primary healthcare institutions nationwide, and to provide reference for optimizing the spatial allocation of healthcare resources and upgrading the level of primary healthcare services.

The data for this study were obtained during 2013-2017 China Health and Family Planning Statistical Yearbook, the 2018-2022 China Health and Wellness Statistical Yearbook, and the annual data of the National Bureau of Statistics (NBS) by province and the Ministry of Civil Affairs of China. From February to June 2023, the health density index (HRDI) was used to comprehensively reflect the demographic and geographic distribution of primary health care in China from 2012 to 2021, spatial autocorrelation analysis was applied to calculate the global Moran's I index to characterize the spatial distribution of primary health care resources in China from 2012 to 2021 analysis, and calculate the local Getis's G index to analyze the hotspots of primary care resource allocation in China from 2012 to 2021.

The number of practicing physicians and nurses per 1 000 population at the grassroots level has increased in all regions of China, and the ratio of healthcare to nursing is still low. The high HRDI values for the number of practicing (assistant) physicians and nurses were in the eastern region, while the western region had lower HRDI values. The global Moran's I index for the number of practicing (assistant) physicians turned from negative to positive in 2016. The Moran's I index for nurses was always negative, but the overall trend was gradually approaching 0. Western regions such as Xinjiang and Xizang have low health density indices and are cold spots for resource distribution.

The allocation of medical and nursing resources to primary health care organizations has been increasing year by year, but there are obvious differences in allocation between provinces. The spatial correlation between physicians has gradually increased, and nurses have become more dispersed in their spatial distribution. It is recommended that the reserve of primary care physicians and nurses be strengthened, and that the ratio and collaboration between physicians and nurses be improved; that the planning of health care resources take into account both demographic and geographic configurations, and that Internet-based health care be promoted to improve the accessibility of health care services; and that the investment of resources in central and western China be increased, and that the construction of health care organizations be pushed forward in order to enhance the capacity of grass-roots-level services.

医护人员是基层医疗重要的服务提供者，在保障民众健康、疾病预防、慢性病管理等方面发挥着重要作用。目前医护资源的研究主要集中在数量、结构等方面，少有针对医护资源的空间分布特征研究。

分析全国基层医疗卫生机构医护人力资源空间发展趋势，为优化医护资源空间配置、提升基层医疗服务水平提供参考。

本研究数据来源于2013—2017年《中国卫生和计划生育统计年鉴》、2018—2022年《中国卫生健康统计年鉴》及国家统计局各省年度数据和中华人民共和国民政部统计数据。于2023年2—6月，采用卫生密度指数（HRDI）综合反映2012—2021年我国基层医护人员的人口与地理分布，运用空间自相关分析，计算全局Moran's I指数对2012—2021年我国基层医护资源的空间分布特征进行分析，计算局部Getis's G指数对2012—2021年我国基层医护资源配置热点进行分析。

我国各区域基层每千人口执业（助理）医师数和护士数量均有增加，医护比仍较低。执业（助理）医师数和护士的HRDI高值均在东部地区，而西部地区的HRDI值较低。执业（助理）医师数全局Moran's I指数在2016年由负值转为正值。护士Moran's I指数始终处于负值，但整体趋势逐渐接近于0。新疆维吾尔自治区、西藏自治区等西部地区HRDI低且为资源分布冷点。

基层医疗卫生机构医护资源配置逐年增加，但各省份间配置差异明显。医师之间的空间相关性逐渐增强，护士在空间分布上更加分散。建议加强基层医师和护士队伍储备，提高医护的配比和协作；医护资源规划应兼顾人口与地理配置，推广互联网医疗改善医疗服务可及性；加大中西部资源投入，推进医联体建设，提升基层服务能力。