An Empirical Study On The Performance Of Financial And Medical Expenditure In Anhui Province

Under the system of fiscal decentralization, local government in China is the main undertaker of the finance health care spending, but total fiscal revenue of local governments is limited at all levels, local governments received widespread attention in the field of medical and health capital allocation and use, especially the spending efficiency research. Fiscal health spending increased with the increase of economic development, fiscal spending increases, as of the end of 2013, the Anhui province health spending absolute size reached 36.18 billion yuan, accounting for the proportion of fiscal expenditure in Anhui province is 8.31%, the proportion of total health spending is 4.40%, ranked second in the central region, the country ranked seventh. Anhui province in the comprehensive implementation of the spirit of Third Plenum of 18 th CPC Central Committee has made a good result to deepen the reform of medical health system, the quantity and quality of service has significantly increased.Improve the efficiency of fiscal health expenditure is the key to promote the healthy and orderly development of medical and health industry. The 17 th National Congress of Communist Party of China put forward "everyone will have access to basic medical and health services", the The 18 th National Congress of Communist Party of China put forward "improving people’s living standard, overall implementation" equal basic public services, "deepening the reform of medical health system" is put forward in Third Plenum of 18 th CPC Central Committee, fourth Plenum of 18 th CPC Central Committee pointed out through the rule of law to promote medical and health work. To solve the problem of "Difficult in seeing a doctor, and costliness in seeking medical care", more focus should be stayed on government spending efficiency of health care, the local government in China mainly responsible in the medical and health spending, so it has important theoretical significance to study the local government health expenditure efficiency, it also has substantial effect for deepening the reform of medical health system.In this paper, we first construct the related theory frame of fiscal health expenditure and analyze the theory basis of local government leading health care spending, from the Angle of public goods and market failure. Through an introduction to the present situation of fiscal health care spending in Anhui province, the paper analyzed the investment in the development of medical and health undertakings of Anhui province from two aspects of expenditure scale and structure, studied the configuration and use of the medical and health resources in Anhui province and the influence of fiscal health care transfer paymentsspending in Anhui province. Studies have found that most of the government at the county level finance health care dependency ratio is higher than the provincial, municipal government. Medical and health resources in Anhui province increased rapidly, but per capita consumption still not high.Using data envelopment analysis(DEA)- the principal component analysis framework with data in Anhui province as an example, studied the province at all levels of government fiscal health care expenditures under the comprehensive technical efficiency, pure technical efficiency and scale efficiency and the key influencing factors. The study found that between 2007 and 2013 in Anhui province overall efficiency of fiscal health care expenditure is not high, the efficiency of the cities there are significant differences between the empirical results. The fiscal income per capita, an ageing population, the Engel’ s coefficient, urbanization rate, such as fiscal revenue decentralization under provincial level indicators are the main reasons for the difference. In addition, the medical and health system reform also has very important effect to fiscal health expenditure efficiency.