A Study On Efficiency Of Municipal Medical And Health Expenditure In Guangdong Province

With the rapid growth of economics, people’s need of medical and health products and services is increasing accordingly. Recently the government has paid more attention to medical and health cause and increased the government medical and health expenditure. While under the background of structural tax reduction, there is contradiction between finite fiscal revenue and infinite fiscal expenditure. So it is necessary to attach importance to fiscal expenditure efficiency and the study of government medical and health expenditure efficiency is very significant. This paper tries to study the municipal medical and health expenditure in Guangdong Province under the frame of scale efficiency, allocation efficiency and production efficiency combined for the first time. On scale efficiency, the absolute amount municipal medical and health expenditure in Guangdong Province ranks first; While from relative scale respect, the proportion of municipal medical and health expenditure to GDP in Guangdong is slightly less than whole national level. But the proportion of municipal medical and health expenditure to fiscal spending in Guangdong is higher than whole national level. On allocation efficiency, the municipal medical and health expenditure in Guangdong differs a lot between regions and there is a great unbalanced distribution of heath resources regionally, as well as urban-rural disparity. Cities with developed economics like Guangzhou and Shenzhen have a much high level municipal medical and health expenditure and abundant heath resources, which precedes those underdeveloped cities. On production efficiency, under the two-stage framework of DEA-Tobit, the municipal medical and health expenditure efficiencies calculated by DEA approach was low during the year 2003 to 2013, and it fluctuated from 0.58 to 0.8 and experienced a descending trend. The efficiencies vary in different cities; Regions(like Guangzhou and Shenzhen) with a high-level expenditure have a lower composite technical efficiency than those with a middle or low-level expenditure. Based on the efficiency scores calculated, we use a limited dependent variable Tobit model to study the relationship between technical efficiency scores and the influencing factors. The results show that fiscal decentralization, medical policy, urbanization level and economic growth ratio have a negative impact on efficiency; While education level and population density are positively correlated with technical efficiency. At the end of this paper, some suggestions are presented to improve health expenditure efficiency. Firstly, municipal medical and health expenditure can be adjusted reasonably and the municipal government should improve capital utilization efficiency. Secondly, it is necessary to invest more in developing to rural medical and health cause thus narrowing urban-rural gap. Thirdly, local officials assessment mechanism and fiscal decentralization system can be improved; Lastly,government ought to accelerate medical reform and the public welfare of medical and health services and develop Internet Plus Medical mode.