Study On The Influence Of Health Resource Allocation,Social And Economic Factors On Per Capita Health Expenditure In China

Objective By analyzing the panel data of health expenditure and health resource allocation of 31 provinces in China,the basic situation of health expenditure,health resource allocation,social and economic level of each province is understood,and the influence of health resource allocation,social and economic factors on health expenditure,as well as the influence degree and difference are discussed,so as to provide reference for the government and policy makers under the condition of limited resources,We should grasp the key factors to control the excessive growth of health expenditure.Method According to the relevant literature review and the availability of actual data,the representative indicators of resource allocation,population characteristics and economic development are determined.The research data mainly come from the "China total health expenditure Research Report","China Health Statistics Yearbook"(2010-2019)and the National Bureau of Statistics website annual data by province.A small part of the missing data were linear filled with fill missing function of MATLAB.According to the different characteristics of the indicators of health resource allocation,social and economic factors,principal component analysis was used to determine the three indicators of health resource allocation,namely,the number of licensed doctors per 10000 population,the proportion of local medical and health expenditure in financial expenditure and the weight of beds per10000 population;According to the weight of each index,31 provinces in China are further divided into high,medium and low demand groups;According to the value of per capita GDP,31 provinces are divided into high,medium and low economic groups.The statistical software of principal component analysis and entropy weight method are spss25.0 and matlab2016 respectively.In order to explore the influence of resource allocation,social and economic factors on health expenditure and the difference between them,the correlation and regression analysis of panel data were carried out with per capita health expenditure as the dependent variable,health resource allocation,social factors and economic level as the independent variables,Statistical software stata15.0 was used for correlation and regression analysis of panel data.Results1.The results of descriptive analysis show that the actual per capita health expenditure,health resource allocation,social and economic factors of 31 provinces are quite different,and the ranking of per capita health expenditure of each province changes little with time.2.The average annual growth rate of health resource allocation fluctuates greatly.The results of classification analysis showed that the indexes of resource allocation,i.e.the number of medical practitioners per 10000 population,the proportion of local medical and health expenditure in financial expenditure and the weight of beds per 10000 population,were 0.42,0.15 and 0.43 respectively.The panel regression results showed that the number of medical practitioners per 10000 population had no significant effect on the provincial health expenditure in the whole country and each group(P≥0.05);The number of beds per ten thousand population had a greater impact on health expenditure,and the regression coefficients were greater than 1(P<0.001),which were 1.3,1.23,1.22 and 1.42,respectively;The proportion of local medical and health expenditure had a significant positive impact on health expenditure(P<0.001),and the regression coefficients were 0.97,1.06,0.87 and 0.9,respectively.3.The changes of social factors are not consistent,and there are great differences between different years and provinces.The results of entropy weight method showed that the weights of three social factors,namely aging,urbanization and mortality,were 0.30,0.30 and 0.39 respectively.In the whole country and each group,urbanization had a greater impact on the total health expenditure(P<0.001),and the regression coefficients were4.03,3.52,4.57 and 3.71,respectively;The regression coefficients were 0.75,0.91,0.25 and 0.48,respectively.However,the descriptive results showed that aging had the greatest impact on the health system;To some extent,mortality represents a health outcome.Regression results show that mortality has no significant effect on health expenditure(P≥0.05).4.The level of economic development had a significant positive impact on health expenditure(P<0.001),but in different economic groups,the proportion of local health expenditure in fiscal expenditure,aging and per capita GDP had a significant positive impact on health expenditure(P<0.001).Only in high economic level areas,urbanization had no significant positive effect on health expenditure(P=0.78),and mortality had no significant effect on health expenditure(P≥0.05).Conclusion On the whole,the average per capita health expenditure of 31 provinces in China is quite different,and the ranking of health expenditure of each province changes little with time.Among them,the number of beds per 10000 population has a greater impact on health expenditure.The increase of the proportion of local medical and health expenditure in financial expenditure does not result in higher health expenditure.Aging and urbanization will increase the consumption of health costs.Among them,the actual impact of aging on health costs is greater,and more consumption of health costs does not bring better health outcomes(mortality).Economic development has a significant positive impact on health expenditure,but the impact of different economic groups,health resource allocation and social factors on health expenditure is quite different.