Abstract
Providing universal quality health services is one of the Sustainable Development Goals (SDG) to achieve by 2030. We evaluated the sustainable and coordinated development of urban and rural medical care from 2008-2017 in Dalian, China, by developing an evaluation system based on population and health services. We used a comprehensive development index model and a coupling coordination model to evaluate the status and sustainable development of population and medical services in Dalian. The overall level of population development index in urban areas was significantly lower than in rural areas in the past decade. Comparing the data for 2008 and 2017, Zhongshan District (-31.51%), Ganjingzi District (-25.67%), Lyshunkou District (-35.45%), and Pulandian District (-19.59%) posted significant declines in the population development index. The overall medical service development index for both urban and rural areas registered a steady upward trend. In terms of the relationship between population and medical services, a more pronounced coupling running-in stage was observed among urban areas than among rural areas. Among urban areas, the coupling running-in stage in Zhongshan District (2013-2016) and Shahekou District (2011-2014) was most pronounced, while among rural areas, Jinzhou District (2012-2016, 0.684~0.756) had the most distinct coupling running-in stage. In terms of coordination development, we found that both urban and rural areas experienced a long period of moderate coordination stage. Among urban areas, except for some middle and mountainous districts with unstable changes in the coordination degree, the overall development trend in the region showed a stable transition from moderate coordination stage towards high coordination stage. From 2008 to 2017, only the coordination degree in Jinzhou District (-9.17%) showed negative growth. Although considerable efforts have been initiated to improve the coordinated development of Dalian's urban and rural populations and its medical services, the medical and healthcare systems still face numerous challenges.