The Research Of Spatial Effect Of Air Pollution On Resident's Health Care Expenditure In China

The health risk and disease burden on residents caused by the air pollution should not be underestimated.China has suffered from the world's highest burden of environmental diseases.Many of existing literatures focus on the residents' health risk and economic cost.Although some researches have identified the relationship between air pollution and health care costs,but they assume the regions are independent of each other.Air pollution has obvious spatial pattern,whether the health care spending will suffer from spillover effect due to the impact of air pollution.Furthermore,the existing research does not consider how the new medical reform carried out by the government together with air pollution on health care expenditures? An important concern is whether the original good intention of new medical reform on reducing health care expenditure will be offset by adverse impact of air pollution?This paper uses spatial econometric methods to sample data to measure how air pollution together with new medical reform policy and related economic variables impacts on health care expenditures with perspective of spatial effects.First,the study carries out descriptive analysis of China's air pollution and health care spending growth,then uses Theil index to measure the regional differences of residents' health care spending in China.Second,the study tests spatial effect of medical expenditure from2002 to 2014 in our country with Moran's I index and Moran's scatter plot.Third,the study constructs spatial econometric model with selection of panel spatial lag model with fixed effect to analyze the factors of health care expenditure.And the direct effect,the indirect effect(spillover effects)and the total effect are used to analysis the driving effect that explanatory variables are on health care spending from local residents and neighborhood residents.Finally,the study summarizes the estimation results with combination of economic theory and social backgrounds to interpret the spatial spillover effects of air pollution,health reform,and other macroeconomic variables on health care expenditures in China.This paper draws the following conclusions.First,the regional differences of residents' health care spending area in our country are gradually narrowing.And the resident health care expenditure has obvious spatial effect and is characterized by "high to high" or "low to low" agglomeration effect.The provincial medical expenditure is notonly affected by the region related factors,and also affected by the residents of the adjacent areas.Second,air pollution not only has directly driving effect on local residents' health care expenditure,but also exerts positive spatial spillover effect on health care expenditure in neighboring region.Third,the impact of macroeconomic variables such as income level,aging level,urbanization level and the number of beds per thousand people,has significant positive effect on the growth of health care expenditure in its local residents,but also exerts positive spatial spillover effect on health care expenditure for its adjacent areas.However,the number of hygienic personnel per thousand has a negative effect on the health care expenditure of residents in the local area and nearby area.Forth,the public service such as Government health expenditure and education level have positive effects on the residents' health care expenditure,the new medical reform dummy variable is inverse.Education level has a positive effect on the health care expenditure of residents in the region and neighboring regions,but the government health expenditure and the new health care reform dummy variables only affects the health care expenditures of residents in the region,and no significant effect on the expenditures in its neighborhood region.So government should jointly supervise the regional air pollution and new medical reforms in order to control the growth of health care expenditure.