Research On Performance Evaluation Of Medical And Health Expenditure In Zhejiang Province

With the development of economy and the improvement of resident health status,the health demand of residents are increasing rapidly.In order to meet the healthy needs.the number of government health investment keeps increasing.However,the limited of resources determines that medical and health expenditure could not infinitely increase.The high growth of health demand and the limited resources require that the current medical and health expenditure must be efficient.As one of economic-powerful province in China,Zhejiang Province has invested a large amount of health finance funds to build a strong health province and improve the health of the whole people.Zhejiang has invested a large amount of health and financial funds to build a health-powerful province and improve the health.However,there still exists serious contradiction between the supply and demand of health services.Therefore,this paper selects Zhejiang Province as the research object to evaluate the performance of medical and health expenditure,which is helpful to know the actual effect of current medical and health expenditure in Zhejiang Province,and finds out the problems in the process of management,in order to improve performance and provides the policy basis.Based on the literature review,This paper defines the key concepts involved in the paper.And based on the fact that the ultimate goal of medical and health expenditure is to improve the health of nation-wide,and the medical and health expenditure needs to influence health outcomes indirectly through the process of medical and health service market.A sectional evaluation framework including process performance and result performance is constructed,which is measured by the efficiency of medical and health expenditure and the health output effect of medical and health expenditure respectively.Firstly,this paper analyzes the scale and structure of medical and health expenditure in Zhejiang Province.The absolute scale and relative scale of medical and health expenditure in Zhejiang Province are constantly growing,but the growth isshowing signs of slowing.At present,the proportion of primary health institutions and public health expenditure is low,and the overall expenditure structure still needs to be further optimized.Secondly.Using the data of 11 prefecture-level cities in Zhejiang Province,the DEA model,Malmquist index and Tobit model were used to evaluate the process performance of medical and health expenditure.The results show that in terms of static efficiency,the overall efficiency level of medical and health expenditure in Zhejiang Province is relatively high,the scale efficiency drives overall efficiency,and the overall efficiency is stable above 0.7,but the overall downward trend is obvious.In terms of dynamic efficiency,the total factor productivity of Zhejiang Province has declined dynamically by an average of 12.7%a year.The low technological progress index has become a hindrance to the improvement of total factor production efficiency.There are obvious differences in efficiency among different regions,The efficiency of Hangzhou,Jiaxing and Huzhou is relatively higher,while the efficiency of Zhoushan,Ningbo and Lishui is lower.In addition,Hangzhou,Jiaxing and Zhoushan has showed strong growth momentum in efficiency,while other regions have showed inadequate promotion momentum.Then this paper has analysis the influencing factors of efficiency.It was found that tiered Diagnosis and "double sinking,two promotion" and fiscal revenue decentralization have a positive impact on efficiency,while fiscal expenditure decentralization,per capita GDP and aging have a negative impact.Thirdly,the performance of outcomes was estimated by macro-health production function.It is concluded that there is a significant positive correlation between medical and health expenditure and residents' health level in Zhejiang Province,and the health output effect of medical and health expenditure in Zhejiang Province is obvious.Finally,based on the research conclusions and the problems found in the performance evaluation of medical and health expenditure,several countermeasures and suggestions are proposed from three aspects: promoting the coordinated development of process performance and result performance,improving process performance and improving result performance.