Calculation Of Municipal Local Health Expenditure Efficiencies And Study On Influencing Factors In Hunan Province

Since the reform and opening up, personal health costs greatly increases. Many people cannot afford to see the doctor. In March2011, in the twelveth five-year plan of state, the government emphasized to increase the financial investment in health service, and provide the whole peole with basic medical health system as public products. With the government’s attention to the medical field continuously strengthening, increasing the scale of government expenditure in health care does solve many problems caused by inefficient health fund. However, the growth of scale is limited. Under the conflict between financial income limitation and government spending, in order to realize the17th Party Congress’s goal that everyone can reach basic health service and solve the problem that people cannot afford to see the doctor, the Ministry of Health clearly put forward to improve the government health spending efficiency while increasing government health spending. But in our country, local governments are mainly responsible for the health investment. So the study on local government health spending efficiency in Hunan not only has important theoretical significance but also has important practical significance in promoting policy implementation.Adopting two-stage analysis framework of DEA-Tobit, this essay initially analyzes the effectiveness of local government health care expenditures and factors in Hunan Province. In the research, the effectiveness of health expenditure shows an increased and fluctuated trend based on the sample data from2003to2008in local governments. The effectiveness varies significantly among local governments. And the social, economic and regulatory variables such as population density, GDP per capita, Engel coefficient of urban and rural residents and fiscal decentralization degree are the significant influencing factors for the effectiveness difference. Under provincial fiscal revenue decentralization index have significantly negative influence on municipal local government health spending efficiency in Hunan. Based on the result, in order to improve the whole government health spending efficiency, we suggest adjusting the scale of expenditure and improving the level of government budget management and health resources planning. Furthermore, based on China’s national condition, we should make under provincial fiscal revenue decentralization play a positive role in enhancing the efficiency of health spending by dividing the basic public health spending responsibilities rationally, building the local government health spending assessment criteria, optimizing local officials evaluation mechanism and gradually reforming household registration system.