An Empirical Study On The Efficiency Of Chinese Government Health Expenditure And Its Influencing Factors

Since the "new medical reform" in 2009,the reform and development of my country’s medical and health services have continued to progress,the coverage of basic medical insurance has been improved,and the health level of residents has also been improved.However,with the changes in population structure,the advancement of industrialization and the changes in the environment,residents’ demands for personal health protection have been increasing and have diversified characteristics,which has put forward higher requirements for the reform of the medical system.At present,the medical and health system is still in the process of continuous reform and improvement.There are problems such as insufficient investment in medical resources,unreasonable allocation of resources,and uneven distribution.At the same time,because the government occupies a dominant position in the medical and health field,government health expenditure is a favorable means for the government to intervene in medical care for health.Therefore,it is necessary to study the current efficiency of government health expenditures and put forward relevant policy suggestions to improve the efficiency,which will help the reform of my country’s medical system.Based on the theory of public goods,the theory of resource allocation and the theory of fiscal expenditure efficiency,this paper adopts the empirical research method to study the efficiency of government health expenditure and its influencing factors.This paper firstly studies the scale of government health expenditure from three aspects:absolute scale,relative scale and elastic change;secondly,it uses the Theil index method to measure the distribution efficiency of its scale,and analyzes the scale of government health expenditure between regions and within regions.Whether the distribution of the data conforms to the principle of fairness;on this basis,select the relevant input-output indicators,use the DEA-Malmquist index model to study the production efficiency of government health expenditures in 31 provinces and cities in my country from 2010 to 2019,and analyze in detail.The total factor productivity across periods and the efficiency values of different provinces and cities are compared.Finally,from a macro perspective,the efficiency values calculated in the previous article are used as the explained variables,and the related factors of economy,society and system are selected as the explanatory variables.The Tobit model is used to empirically analyze how macroscopic external factors affect the efficiency of government health spending.This paper finds that: First,the total scale of government health expenditure in my country grows slowly,and the part borne by the government shows a downward trend;the results of the Theil index analysis show that intra-regional differences are the main reason for inequitable distribution,that is,it is the phenomenon of uneven distribution of health resources between urban and rural areas.Second,the medical and health expenditure efficiency of Chinese local governments generally shows a downward trend.The reason for the decline is the decline in technological progress.In addition,there are certain efficiency differences between regions;third,from the perspective of technological efficiency changes,the government’s efficiency of medical and health spending has changed slightly over time since 2010.For different provinces and cities,there are still inefficiencies in some provinces and cities in terms of pure technical level and scale.Fourth,the empirical results show that the two factors of fiscal expenditure decentralization and fiscal self-sufficiency rate have a negative impact on efficiency,which shows that my country’s fiscal decentralization system is not conducive to the improvement of health expenditure efficiency;population density,urbanization level,aging The level also plays a negative role;and when local government fiscal revenue increases,it will significantly improve the efficiency of health spending.In addition,the empirical results for regions divided by different ways are similar.According to the research conclusions,this paper puts forward corresponding policy suggestions.First,we should appropriately increase the scale of government health spending;second,we should adjust the distribution of government health spending between regions and between urban and rural areas;third,we should focus on technological innovation and promote technological innovation.The fourth is to rationally reduce the degree of fiscal decentralization and establish a reasonable evaluation mechanism for officials.