The Performance Of Medical And Health Expenditure In Shandong Province

The construction of people’s livelihoods is significantly impacted by public medical and health care,and a fundamental endeavor to raise the health of inhabitants and advance the equalization of public amenities is essential.As China’s economy enters the new normal,the fiscal deficit is also becoming more and more normalized,and the contradiction between the financial deficit and the budget fund demand for the construction of medical and health services is prominent.It is thus of utmost importance to sharpen the concentration on the execution of medical and health financial expenditure,so as to augment the effectiveness of medical and health financial expenditure and the level of equalization of distribution,thereby guaranteeing citizens’ health requirements and advancing the lasting advancement of medical and health undertakings.This paper concentrates on the performance of medical and health expenditure in Shandong Province,based on public product theory,principal-agent theory,new public management theory,and new public service theory.A current situation analysis of medical and health expenditure in Shandong Province from 2010 to 2020 was conducted,utilizing the cities of the province at all levels as the sample.The majority of medical and health expenditure in Shandong Province was devoted to the building of public hospitals,yet the construction of primary medical and health institutions and public health is still weak.There is an unequal distribution of medical and health resources between urban and rural areas.Secondly,the DEA-Mamlquist technique is employed to thoroughly evaluate the efficiency of medical and health expenditure in Shandong Province from both a static and dynamic viewpoint.The provincial medical and health financial expenditure in Shandong Province is,from a static perspective,not very efficient,and the highest value is only 0.858,with pure technical efficiency being the primary limitation.The comprehensive technical efficiency of medical and health financial expenditure in cities at all levels is highly varied.Ultimately,the state of the medical and health financial expenditure in Shandong Province is in diminishing return to scale,with more efficiency losses.From a dynamic point of view,the total factor productivity of Shandong Province has a negative growth in most years,and the overall trend is downward.By decomposing the Malmquist index,it is found that Shandong Province has a good ability to use the existing medical and health technology,but the medical and health technology innovation is relatively lagging behind,the overall decline of total factor productivity of medical and health expenditure is seen,with significant regional differences in total factor productivity.And in areas with higher economic level,total factor productivity is not necessarily high.Thirdly,the panel Tobit model of the maximum likelihood method is used to test and analyze the factors that affect the efficiency.The empirical results show that the per capita GDP,population density and urbanization level have a positive effect on the efficiency of medical and health expenditure in Shandong Province,while fiscal revenue decentralization and government investment have a significant inhibitory effect.Finally,by measuring the Taier index of medical and health financial expenditure of 16prefecture-level cities in Shandong Province,which is weighted by GDP,population and financial expenditure,the fairness of medical and health financial expenditure in Shandong Province is analyzed.The degree of equalization of medical and health financial expenditure in Shandong Province is relatively high,and the equalization level still has great room for improvement.Based on the above analysis,this paper believes the structure of medical and health expenditure can be continuously optimized;encourage and support R&D and innovation of medical technology;improve the fiscal decentralization system;efforts should be undertaken to normalize the assessment of medical and health expenditure performance,enhance its efficiency,and ensure equitable allocation of medical and health expenditure and promote the construction process of healthy Shandong.