The Benefit Incidence Analysis Of Medical Public Service In China

Public services concern people’s livelihood and connect people’s hearts.Medical and public service is one of the major livelihood projects of Chinese government.On the one hand,the financial expenditure in the medical field continues to increase,indicating that the government has strengthened the supply of medical public services.On the other hand,from the micro point of view,there is still room for further research on the effectiveness of individual enjoyment of medical public services.In order to enable different groups to enjoy public medical services fairly,and at the same time let the government invest in public medical services more efficiently,so as to achieve the goal of fairness and efficiency.Based on the data of China Family Panel Studies from 2012 to 2018,this paper uses the two-part model to establish the individual medical decision model and the total medical cost model to reflect the individual demand for medical public services.Further,by investigating urban and rural subgroups and different income subgroups,matching the macro data of financial subsidy,and comparing the effects of financial subsidy on Chinese residents’ medical choice decision-making and medical expenditure decision-making.Then,under the framework of benefit incidence analysis,the benefit incidence of medical public service is evaluated,and the future path of financial investment in medical public service is provided for reference through policy simulation.This article consists of five parts.The introduction introduces the background and significance of the topic,research trends and literature review,research methods and ideas,innovation and shortcomings.Chapter one is the concept definition and theoretical basis.It introduces the concept of medical public service and the problem of interest destination in detail.Chapter two is the status analysis of medical public service.From the two perspectives of government supply and residents’ benefits,this paper analyzes the importance and supply of medical public services paid by the government and the use of medical public services at the individual perspective by macro and micro data.This part provides realistic basis for the subsequent empirical analysis.The third chapter is the analysis of the benefit incidence of medical public service.Firstly,the framework of benefit incidence analysis is introduced,and the basic methods and data sources adopted in this paper are expounded.Then,based on the estimation results of individual demand function,the marginal benefit incidence is measured,and the individual benefit trend is described intuitively through the concentrated curve.Chapter four is the research conclusion and policy recommendations.The research conclusions are as follows:(1)From the perspective of government supply,governments at all levels are investing more and more in health,and the emphasis of the government and the whole society on health and residents’ health is also increasing year by year.(2)From the perspective of individuals,the hospitalization rate and outpatient utilization rate both increased significantly in the survey years,and the possibility of not using medical services when sick showed a downward trend.Lowest-income groups and rural individuals are the main reasons for this change.The proportion of self-pay among different groups increased to different degrees.In terms of the choice of medical institutions,the proportion of people who choose hospitals is increasing year by year,and urban individuals and individuals with the highest income are the main force to choose hospitals.At the same time,there is a large gap between different income groups in the choice of medical institutions.The satisfaction of individuals to medical institutions increased significantly from 2012 to 2018.However,for individual survey years,satisfaction was lower among the top 25% and urban individuals.(3)For medical treatment decision-making,financial subsidies play a positive role in medical treatment behavior.The price of medical service,the choice of medical institutions and the proportion of medical expenses out of pocket have significant effects.In the choice of medical institutions,people are more likely to choose hospitals rather than primary medical institutions.For medical costs,the impact of subsidies is starting to show.The positive effects of the price of medical service,the medical level of medical institutions and the accessibility of medical resources show an increasing trend year by year.Out-of-pocket medical expenses also significantly affect total medical expenses.(4)The results of marginal incidence show that the elastic distribution of demand for financial subsidies basically conforms to the "pro-poor" model and is developing in favor of low-income groups.Further analysis of net benefit incidence after deducting out-of-pocket expenses shows that the net benefit of public health services is relatively more equal than that of income distribution,and the benefit has expanded for low-income groups.The benefit concentration curves in 2014 and2018 also further confirm that low-income groups bear less cost of medical public services and their benefits increase.(5)The results of policy simulation show that reducing the price of public medical services,whether it is reducing the service price or reducing the out-of-pocket proportion of medical expenses,can promote the income increase of low-income groups.Rural residents benefit more from reducing the selfpaid rate of medical expenses than urban residents.Urban residents,for their part,would benefit more from reduced access to medical services.Reduced access increases benefits by enabling people to seek care that is more tailored to their needs.The above research conclusions have important reference significance for promoting the development of Chinese medical public service,so that different groups can enjoy the medical public service fairly,and also provide policy advice and guidance for improving the financial supply capacity,meeting the demand of residents under the guidance of efficient and high quality medical public service supply.