Cross-District Healthcare-Seeking Behavior Analysis Using Two-stage VaDE Clustering Approach: A Case Study of District A, Shanghai

Corresponding author: cuixin, cuixin@wsjkw.sh.gov.cn

DOI: 10.12201/bmr.202509.00039

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  Abstract: Objective: Based on outpatient and emergency visit data, this study employs a staged VaDE model to uncover the heterogeneity structure of residents’ healthcare-seeking behaviors and reveal cross-district mobility patterns. Methods: Outpatient and emergency visit records of permanent residents in District A, Shanghai, in 2024 were used. Each individual visit served as the analytical unit. A staged VaDE approach was applied for nonlinear dimensionality reduction and clustering, followed by feature analysis with cross-district visit rates. Results: The proposed model outperformed K-Means and VAE+K-Means in clustering performance, identifying seven typical healthcare-seeking patterns with significant differences in cross-district rates, demographic characteristics, care structures, and disease profiles. Cluster 1 comprised elderly patients with severe conditions and high cross-district rates; Cluster 2, young and middle-aged cross-district commuters; Cluster 3, mild-case or maternity-oriented visits; Cluster 4, infrequent visits by middle-aged and elderly patients; and Clusters 5–7, local chronic disease or low-burden visits. Conclusion: The staged VaDE model demonstrates strong capability in characterizing behavioral heterogeneity and identifying key cross-district mobility types, providing evidence for refined healthcare service management and regional coordination.

  Key words: VaDE; Cross-District Healthcare-Seeking; VAE; K-Means

  Submit time: 16 September 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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