An Empirical Study On The Efficiency Of Local Government Health Spending Based On DEA

With the continuous progress of reform and opening up, in three decades of government health spending in part through the personal commitment of substantial growth,"difficult and expensive" development of health care has become a major cause of chronic illness. March2009, the CPC Central Committee of the State Council promulgated the "Opinions deepening medical and health system" on the proposed overall goal of "progressive realization of universal access to basic health care services". Twelfth Five-Year Plan, issued in March2011stated that the government should gradually expand into health care, basic health care spending will be as a public goods provided to all the public.2012Report of the party’s18clearly stated,"perfect raise the level of national health policy, is committed to providing security for the public, effective, convenient and affordable public health products, and basic health services."Increasing the size of government investment in the health sector. But in the long run, the spending of this magnitude must be limited. At the same time, in terms of revenue but also has limited nature of both conflicts to be resolved will affect the validity of the future development of China’s medical and health services to a large extent. Accordingly, the state health department to emphasize that we can not simply rely only on the government to expand the scale of investment in health care to the development of medical and health services, need to pay more attention to efficiency. In this context, this paper, using the DEA method of local government health spending efficiency empirical research.There are four sections of the full text can be summarized summarized as the following three main parts:Part Ⅰ:Theoretical basis for empiricalMainly defines several important concepts of efficiency of government health expenditure related research, while separately from the supply, demand, technological advances three perspective of the relationship between economic growth and government health spending efficiency. This part belongs to the theoretical part of the study.Part Ⅱ:Expand the empirical research and summarize empirical resultsAs a core part of this article, this section attempts to use the method of DEA CCR and BCC models and Malmquist productivity index is based on cross-sectional data and panel data on China’s31provinces, autonomous regions and municipalities directly under the government health health spending efficiency five years2007—2011were estimates, and on the results of a comparative analysis of DEA estimates of31local governments respectively, from the perspective of the static and dynamic and geographical cross-section and time-series two dimensions.Empirical studies have concluded as follows:(1) Higher overall spending efficiency but mostly not optimal scale of expenditureAt this point in time on the2011Medical Expenditure efficiency of health of the local government is relatively high, but most did not reach optimal investment scale, there are some local government expenditure efficiency technology effectively there is a great distance away, while10local government input redundancy occurs beyond the optimal scale of investment, the emergence of health resources utilization efficiency is not high phenomenon.(2) The time series of the efficiency of the overall spending on the rise2007—2011five-year period, from the time series point of view, the efficiency of government health spending overall health of local governments on the rise, but there are slight decline in volatility in2009.(3) A comprehensive technical efficiency between the lateral regions than in the eastern and western regionsPartly because the pure technical efficiency is higher than in the western region, on the other hand is due to return to scale efficiency is also higher than in the western region.(4) The existence of redundant inputs and technical and scale efficiency while the phenomenon of non-effectiveBeijing and Zhejiang in the five years of returns to scale persistent decrement, indicating the size of its existing investment has exceeded its goal of optimal size, exacerbated by the non-effective comprehensive technical efficiency, or even lower. Most places in the west there are both "technical non-effective" and "non-effective scale" that is, the simultaneous existence of government health resources into technical inefficiency and there into small-scale problems.(5) Changes in the overall efficiency of the integrated technology is rising but the technical changes in the level of instabilityWith Malmquist productivity index dynamic analysis found that changes in the consolidated technical efficiency overall upward trend, although the increases and decreases, but the change in volatility is not, change is relatively stable; technical level five years overall small decline experienced first stable, after sudden increase in three stages and then cooling; TFP five years overall small decline, its trends and changes in trends remained the same level of technology, we can see changes in TFP fluctuations mainly from technological change instability.Part Ⅲ:Empirical results for the proposed measures to improve the problemIn conclusion drawn on the basis of empirical research, targeted health expenditure proposed to improve the efficiency of local government’s five-point health policy recommendations.This article features and major innovations:(1) To complete the country’s31local government as an empirical study, in constructing the index evaluation system to economy, efficiency and effectiveness, based on the input factors into investment in human capital physical capital investment, capital input, input, output variables and from government health spending, health services utilization, and health services to ensure efficiency level three angles subdivision evaluation results are valid.(2) In research methods, geographical and vertical cross-sectional time-series analysis comparing the combination; addition to the panel based on data extending to a dynamic research study on the basis of a static, BBC DEA method, CCR model analysis and Malmquist production function index analysis combining breaking the traditional static analysis based practice.