Optimization of Health Service Utilization Among Elderly People With Chronic Diseases in Rural Ethnic Minorities in Northwest Yunnan Using Graph Neural Networks.

Background: The demand for health services among elderly patients with chronic diseases in rural ethnic minority areas of northwest Yunnan is increasing. Yet, service utilization remains imbalanced. Existing studies mainly focus on disease combinations, overlooking temporal and spatial variations in medical behavior. Methods: This study applies graph neural networks to construct a heterogeneous graph integrating patients, medical institutions, and geographic units, modeling dynamic service paths to identify high-frequency and potentially lost-contact patients. Using a heterogeneous graph attention network for feature embedding and a graph attention network classifier, the model captures behavioral similarity and service path patterns. Geographic and social variables such as ethnicity, terrain, and road accessibility further enhance sensitivity to regional disparities.Based on node centrality and path distribution, targeted service optimization strategies-such as mobile medical points and cross-regional collaboration nodes-are proposed for resource allocation. Results: Experimental results reveal marked spatial and structural disparities: Diqing Prefecture shows an accessibility index of 68 min versus 29 min in Dali; multimorbidity (3+) groups have a 68.6% matching rate but a 1.138 utilization rate, indicating resource imbalance; and mountain unit G18's coverage index is only 0.31. Conclusion: The proposed model achieves a Macro-F1 of 0.83, outperforming XGBoost (0.76), effectively identifying high-risk groups, locating service bottlenecks, and supporting precise health resource optimization.