Study On The Efficiency Of Medical And Health Expenditure In Anhui Province Based On The Three-stage DEA Model

Since the new round of medical and health reform in 2009,China has made remarkable progress in the field of health care.However,as the reform began to enter into a series of problems,such as the critical period and deep water period and the new normal of China's economic development,all of them put forward higher requirements on deepening the reform of medical and health system in China.In the face of the health development of our country is experiencing more serious challenges than ever before,The State Council on December 27,2016,officially issued by the The Thirteenth Five-year Plan in deepening the reform of medical health system planning.The government hopes that during the The Thirteenth Five-year Plan period,China will gradually resolve the deep-rooted institutional conflicts in the field of medical and health care,and implement the plan for everyone to enjoy basic medical and health services in 2020.The new medical reform plan stipulates that in the field of basic medical and health,we should always adhere to the principle of government leading and playing the role of market mechanism.It is clear that the government has a major responsibility in the field of health care,and it also establishes a diversified health input mechanism,which is led by the government.Under the current fiscal decentralization system,the health expenditure of local government is the main body of the government-led diversified health input mechanism.Since the implementation of the new reform,local governments have expanded their spending in the field of medicine and health in the past 10 years.By the end of 2016,the total medical and health expenditure in Anhui has reached 48 billion yuan,an increase of 2.9 times compared with 16.6 billion yuan in 2009.But the rapid growth of health expenditure scale is moderate,the capital of the configuration of the structure is reasonable and whether spending significantly improved the quality and quantity of medical and health resources and other issues have become the focus of domestic and foreign scholars attention.Therefore,it is of great theoretical and practical significance to study the health expenditure efficiency of local government to achieve the goal of basic medical and health service for all people in the new medical reform.The paper first explains the theoretical basis of government intervention in health field.Then,the current situation of medical and health in Anhui province is analyzed mainly from the scale and structure of health expenditure,medical and health resources and services,and the basic situation of new rural cooperation.Results show that the rising number on medical and health resources in Anhui province as a whole,but growth is declining,at the same time,governments at all levels of medical and health care dependency ratio difference obvious,at the county level health dependency ratio is significantly higher than the municipal government.This paper mainly studies the health expenditure efficiency and its influencing factors in 16 citiesof Anhui province from 2011 to 2016 with the revised non-expected output three-stage DEA model.The results show that the main reason for the inefficiency of the cities in the first stage is the unreasonable management of health expenditure and the unreasonable distribution of the structure.The second stage is the per capita GDP,the percentage of the medical and health expenditure of general budget expenditure,education level,the urbanization rate is the main factor affecting the efficiency,and no obvious correlation between per capita income level and efficiency.The third stage shows that health expenditure in Anhui province is not high.The main reason is that the size of health expenditure in each city has not reached the optimal scale.In terms of pure technical efficiency and scale efficiency score of 0.9 as the critical value,Anhui province is divided into four different types.According to the calculation,only Hefei is in "double height",and the rest of the city is in "double bottom" and "high and low".Finally based on the theoretical analysis and empirical test in the article,mainly from the optimization of government health expenditure scale,improve the level of budget management and planning of health resources,perfect the mechanism of health assessment of local government as well as excellent guide the social capital into the medical and health field these four aspects to promote the efficiency of the local government expenditure on health policy.We hope to provide support for the government's formulation of medical and health policies.