Research On The Efficiency Of China's Public Health Expenditure Under Fiscal Decentralization

As the social principal contradiction has shifted in recent years,the government has prioritized and increased the investment in cultural,educational and general healthcare related perspectives.Among which,the development of public healthcare directly and closely links to the quality of life for the majority of residents.Over the years,the development of the domestic health system has made remarkable progress,and the level of medical care has also been improved.The government's expenditure on public health has increased year by year,to a certain extent,alleviating the lack of public health investment caused by the backward economic level in the early stage.However,during the operation of government funds in the field of health,problems such as inefficient use and uneven regional distribution have emerged.Therefore,the Chinese government launched a new round of health care reform in 2009.The "Decision" of The Third Plenum of the 18 th CPC Central Committee also clarified the reform directions such as optimizing the public health system,establishing an efficient health performance evaluation system,and clearly dividing government responsibilities at all levels.It is now in the stage of deepening the reform of my country's medical and health reform.How to improve the efficiency of my country's public health expenditure from the perspective of the financial system is not only the focus of deepening medical reform,but also the promoter of improving my country's financial expenditure structure.There is no doubt that this is of great significance to the development of the country's livelihood.This article explores the impact of fiscal decentralization on my country's public health expenditure efficiency based on macro-health economics,public goods and other theories.Firstly,the concepts of public health expenditure,export and fiscal decentralization are defined.Then through theoretical analysis to explore the influence mechanism of fiscal decentralization and public health expenditure efficiency.Summarize the development of public health in my country under different financial system stages,and combine the data in recent years to discover the current problems of public health expenditure in my country.Finally,214 prefecture-level and city-level data from FY2010 to 2016 were selected for the three-stage DEA efficiencyevaluation to explore the impact of fiscal decentralization on healthcare expenditure efficiency.The specific structure of this article is as follows:The first chapter summarizes related theories.Lay a theoretical foundation for this article from the perspective of economics and finance.And elaborates the influence mechanism of fiscal decentralization on the efficiency of public health expenditure from three aspects: government competition,local government information advantages,and financial power distribution.The second chapter analyzes the state of China's public healthcare expenditure since the founding of New China in conjunction with our fiscal system.This chapter analyzes the construction process of China's public health system under different fiscal systems and uses data to show the current state of China's public healthcare expenditure,and finally explores the problems of our public healthcare system.The third chapter is empirical research through econometric models.The first step is to set the appropriate input-output variables and environmental variables,use the three-stage DEA model,remove the impact of environmental factors and random disturbances,and evaluate the health expenditure efficiency of 214 prefecture-level cities in my country.In the second step,combined with the aforementioned impact mechanism,uses the Tobit model to verify the relationship between each element and expenditure efficiency,so that the direction of reform can be clarified.The fourth chapter summarizes the successful experiences of the developed and developing countries in the world,such as the United Kingdom,Germany,and Russia,in improving the efficiency of health expenditures,and provides directions for my country's public health reform.The fifth chapter puts forward policy suggestions to improve the efficiency of public healthcare expenditure under current fiscal system.First of all,the basic conclusions drawn from the previous articles are summarized,and then targeted solutions are proposed for improving the efficiency of public healthcare in China from the three aspects of improving the public health system,optimizing the financial system,and exploring multiple governance models.