A Study On The Impact Of China's Fiscal Medical And Health Expenditure On Residents' Health

With the continuous development of China's economy and the continuous improvement of people's living standards,Chinese residents' demand for health is also gradually increasing,expecting to have better public health conditions and medical resources and facilities.In view of this demand,although the Chinese government has increased the investment in medical and health care,the investment structure is also adjusted accordingly,but in recent years,the phenomenon of "difficult and expensive to see a doctor" has gradually emerged,which has a certain negative impact on the health of residents.In such a context,a comprehensive analysis of the performance of financial medical and health expenditure and its influence mechanism on the health level of residents is of great significance for China to implement effective improvement measures,formulate reasonable related policies and promote the overall health level of residents.This paper first analyzes the scale and use structure of medical and health expenditure in our country.The grey correlation method was used to determine the weight of indicators,and the DEA model of grey correlation constraint cone was constructed to evaluate the efficiency of fiscal health expenditure on health effects from different years and different regions.Then,using the panel data of 31 provinces and cities in China from2004 to 2018,and based on Grossman's health demand theory,a Chinese macro health production function was established to study the specific impact of government health expenditure on the health level of residents by using fixed-effect model and first-order differential GMM estimation.Then the panel threshold model was used to study whether the threshold effect existed in the model with the number of doctors per thousand population as the threshold variable.Finally,it analyzes whether the functional expenditure of government health expenditure has a significant effect on the health of residents.The research results are as follows: First,from the analysis of the efficiency change trend in different years,the overall efficiency shows a continuous improvement trend,but only 2003 is shown to be DEA effective;The efficiency values of different regions are different,and the total technical efficiency of most regions is in a very low state,which is mainly due to the poor pure technical efficiency.Second,through the comparative analysis of the fixed-effect model and the differential GMM model,it is found that the difference GMM model with the endogenous variables removed has a more significant result,and the government health expenditure has a significant positive effect on the health level of residents.Third,the model has a threshold effect,with the number of practicing doctors per thousand population increasing,the government expenditure on health impact on residents' health level will have different degree of change,promotes residents health level within a certain scope,but blindly pursue the government expenditure on health of high investment,can lead to low efficiency,easy to cause the waste of resources.Fourthly,the four functional expenditures of government health expenditures have different impacts on residents' health.Due to the high correlation between variables,some functional expenditures do not have significant impacts on residents' health.