Research On Measurement Of Health Expenditure Eficiency Of Local Governments In China

Since the implementation of the reform of the medical and health system in China,the medical and health undertakings have achieved rapid development.However,more than 30 years after the implementation of the reforms,with the continuous development of China’s medical and health services and the improvement of people’s health awareness,it is difficult for China’s medical and health service system to meet the needs of achieving the goal of “everyone enjoys basic medical and health services”.The rapid growth in the total cost of health,the “difficult to see a doctor,expensive to see a doctor” and other issues are still outstanding,and the relationship between doctors and patients has become increasingly tense.Therefore,the issue of the government’s efficiency in the provision of public health services has attracted the attention of all sectors of the society and has also become the focus of many scholars’ research.By reading the existing literature,it is found that scholars at home and abroad have conducted exploratory research on the efficiency of expenditure on government health and have achieved fruitful results.Some scholars believe that due to exceeding the optimal investment scale,developed regions should appropriately reduce input,so as to make up for medical resources in backward areas.The larger the investment,the lower the efficiency.However,some scholars believe that the reason for the low efficiency of China’s government health expenditure is that the investment scale is too small.In addition,the studies of these scholars have neglected the study of the efficiency of inter-regional public health expenditures.However,the level of economic and social development among regions in China differs significantly.The calculation of expenditure efficiency in different regions will inevitably have to take into account regional disparities.On the basis of these predecessors’ researches,relevant data from the China Statistical Yearbook,China Health Statistics Yearbook,and China Financial Yearbook were obtained,and the DEA-Malmquist method was used to re-measure the government health in various regions in China from 2005 to 2015.The static efficiency and dynamic efficiency of expenditures are analyzed at the same time,and the convergence of efficiency is analyzed.On this basis,the spatial spillover effects of various regions’ efficiency are further analyzed and the following conclusions are drawn: First,there is a significant difference in the health expenditure efficiency of our government.The efficiency of government health expenditure in most parts of China is in the phase of diminishing returns to scale.Second,the main reason for the low productivity of China’s government health expenditure is that the efficiency of technological progress is too low.Thirdly,the total factor productivity of the government’s health expenditure in the eastern,central,western,and northeast regions of China has absolute convergence and relative convergence,and its convergence is northeast>west>middle>east.Fourth,from the perspective of spatial spillover effects,the increase in the proportion of urban population and population density will increase the efficiency of local government expenditure on health expenditure,while the increase in government health expenditure as a percentage of fiscal expenditure and GDP per capita will inhibit the increase in the efficiency of local government expenditure on health.The decomposition of the spatial Dubin model found that the proportion of government expenditure on health expenditure to expenditure and GDP per capita will have an inhibitory effect on the improvement of the efficiency of government health expenditure in the region.The increase in the proportion of urban population and population density will increase the efficiency of the government’s health expenditure in neighboring regions,while the increase in illiteracy and GDP per capita will inhibit the efficiency of government health expenditure in neighboring regions.Finally,this article summarizes empirical analysis and puts forward corresponding policy recommendations based on empirical analysis results.