Factors Associated with Medical and Health Talent Agglomeration at the City Level in China: Economic, Social, and Ecological Perspectives

Background: Medical and health talent (MHT) is a core strategic resource for safeguarding public health. Understanding the factors associated with MHT agglomeration is essential for improving healthcare workforce planning and optimizing the allocation of health resources. Methods: Using panel data from 285 prefecture-level cities in China spanning 2004–2019, this study extended the previously established multidimensional framework for analyzing MHT agglomeration encompassing density, scale, intensity, and equilibrium to a longitudinal urban setting. Spatial autocorrelation analysis and a two-way fixed effects panel model were used to examine economic, social, and ecological factors associated with MHT agglomeration. Robustness tests, endogeneity checks, and heterogeneity analysis were also conducted. Results: The spatial autocorrelation analysis reveals that the spatial distribution of MHT exhibits a generally random and dispersed pattern. Urban hospital beds per 1000 population maintained a significant positive association across all model specifications, representing the most robust factor associated with talent agglomeration. Sci-tech expenditure exhibited nonlinear association, while ecological factors displayed pronounced dimensional heterogeneity and regional differentiation. Conclusions: MHT agglomeration is associated with factors across multiple dimensions, with hospital bed capacity showing a particularly consistent association.