The Research On Health Care Fiscal Expenditure Efficiency In Gansu Province

Since the launch of the reform and opening policy in 1978, we have attained great achievements in our medical and sanitary cause, although our medical and sanitary cause has developed rapidly, there are plenty of problems still exist in the process of it’s development. For example, the development of the healthcare in China is imbalanced regionally, and between urban and rural areas, medical security system is imperfect, the problem of inappropriate distribution of medical and health resources is still exist. The conflict between the development of the healthcare and people’s need for healthcare gradually becomes salient, which makes it become a very important task for the government to further enhance the development level of the medical and sanitary cause. It is necessary for the government to increase the health care fiscal expenditure in order to develop the medical and health undertakings, which can solve many problems caused by the inadequate investment in the past, but it is not enough to increase the investment, it is also needed to focus on improving the efficiency of health care fiscal expenditure, only if combine the increasing scale with improving efficiency could we achieve a long-term development of the medical and health cause.This paper for the first time takes Gansu Province as the researched area, studying on the health care fiscal expenditure efficiency, takes the 14 local governments health system in Gansu Province as decision making unit, uses the panel data of 14 local governments in Gansu province from 2007 to 2013, makes a research on health care fiscal expenditure efficiency and influencing factors in Gansu province by using data envelopment analysis、Malmquist productivity index and Tobit model. The main conclusions are as followed: First, the health care fiscal expenditure efficiency in Gansu province showed a “V”-shape trend from 2007 to 2013, efficiency are tending upward after 2010, the scale of the health care fiscal expenditure gradually tends to be the optimal scale. Secondly, local health care fiscal expenditure efficiency vary widely among different regions, the health care fiscal expenditure efficiency of Lanzhou City、Jiayuguan City、Jinchang City and Longnan City are higher than the other areas. Thirdly, the Malmquist productivity index analysis indicated that all local governments total factor productivity index less one, most regions should promote the utility efficiency of the existing technology. Fourthly, Tobit model analysis showed that Engle coefficient of urban、the level of urbanization and fiscal decentralization degree have significant positive impact on the health care fiscal expenditure efficiency. This paper puts forward some policy recommendations from the main conclusions: steadily enlarge the scale of health care fiscal expenditure; improve governmental budget expenditure management level; further perfecting fiscal decentralization system; strengthen the supervision of the government health care fiscal expenditure; deepening the medical and health system reform.