The Research On Public Health Spending Efficiency In Sichuan Province

While strengthening the provision of public health services and promotion of health care reform, the central government and governments of all levels allocate an increasing fiscal fund for health care. Fiscal decentralization makes local governments the main bearer of health investment. Because of the limited sources of revenue for local governments, putting financial funds in the public health field become more rational and efficient is the focus of attention. With the development of economy and society, the financial health of the Sichuan Provincial Government expenditures continues to grow to a certain size. After2008, the health care spending in Sichuan Province is ahead of the national average. In2011, Sichuan health fiscal expenditure reached37.296billion Yuan, accounting for5%of the national health care spending, ranking second in the country. Sichuan Province, also achieved good results in Medical reform. And three cities in Sichuan Province, was named the National Health City, Chengdu, Luzhou, Mianyang.Therefore, the research on the health care spending efficiency of Sichuan Province has important practical significance for the promotion of all levels of government more scientific and rational development and implementation of health policy.Firstly, the paper defines the connotation of government health field of financial expenditure related concepts and efficiency. The fiscal expenditure efficiency of the government health is expressed as the ratio of the inputs and outputs of the government for health services, and analyzes the economic efficiency of specific meaning in the text. Then the paper introduces the theory of public finance and the theory of public goods involved in the study. And it continues to introduce the main evaluation methods of the health care, and follows to the details of data envelopment analysis(DEA)which has a widespread international use applying to most areas of health. DEA is planning to use mathematical models to evaluate the relative effectiveness of "department" or "unit" which has multiple inputs and in particular multiple outputs. The features of multiple inputs and outputs of medical and health care make more applicability and superiority for the DEA model used in the field of health care sector.The study of the efficiency of fiscal spending on the public health is to examine the level of government fiscal funds management, and it uses the analysis of influencing factors to improve the level of the government’s management. The paper first analyzes the current situation of the health of financial expenditure in Sichuan Province in the empirical section:from the perspective of the absolute scale of expenditure and the relative scale of expenditure effects of health investment in Sichuan Province, and compared the health expenditure scale of Sichuan Province with the national average.Then the paper make a simple analysis of the changes of health resources in Sichuan Province and medical services, as well as the new rural cooperative medical care. On this basis, using data envelopment analysis and Malmquist productivity index to study the static and dynamic efficiency of the Sichuan provincial government health expenditures. The study found that the overall improvement of the Sichuan provincial government health spending efficiency (technical efficiency, pure technical efficiency, scale efficiency), while there is a clear regional differences, and a simple analysis of some areas of efficiency score differences influencing factors. Finally, adopting Tobit model to analyze the factors that affect the efficiency of government expenditure on health. And the social, economic and regulatory variables such as population density, GDP per capita, Urbanization rate, the level of education, Engelcoeffcient of urban and rural residents and fiscal decentralization degree are the significant influencing factors for the effectiveness difference. Based on the result, in order to improve the whole government health spending efficiency, we suggest to adjust the scale of expenditure and improving the level of government budget management and health resources planning. Furthermore, based on Chinese 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. This way will be a positive impact on improving the efficiency of government health spending.