| The development of the medical and health field is closely related to people’s life,which guarantees people’s basic health level.However,the effective supply of medical and health resources in my country is relatively insufficient,and the problem of "difficulty in seeing a doctor" still exists.Since the new medical reform,my country’s local governments have gradually increased their investment in medical and health services.However,major hospitals are overcrowded,experts are hard to find,and even some residents have not been effectively resolved.Therefore,this paper improves the supply of medical and health resources by exploring the efficiency of government medical and health expenditure,so as to alleviate the problem of "difficulty in seeing a doctor".The research object of this paper is the government medical and health expenditure efficiency of 31 provinces(municipalities and autonomous regions)in my country from 2010 to 2019 after the new medical reform.This paper uses data envelopment analysis(DEA)to analyze the efficiency of local government medical and health expenditure,and studies the internal reasons for the difference in the efficiency of local government medical and health expenditure in the time dimension and space dimension,including the local government’s budget management ability for medical and health expenditure.And the rationality of the scale of government health care spending.And further use the Malmquist method to analyze the impact of changes in the technical efficiency of local government medical and health expenditures and changes in technical levels on productivity changes.In addition,on the basis of analyzing the efficiency of local government’s medical and health expenditure,the Tobit model is used to analyze the external environmental factors that affect the difference of local government’s medical and health expenditure efficiency.Through research,it is found that from the perspective of time dimension,the average scale efficiency level of local government medical and health expenditure is higher than the average pure technical efficiency.In terms of dimensions,there are large regional differences in the efficiency of local government health care expenditures;in terms of dynamic analysis,technological regression is the main reason for the decline in productivity,but the momentum of technological regression is weakening.From the analysis of influencing factors,fiscal revenue decentralization and fiscal expenditure decentralization have a negative impact on the efficiency of local government medical and health expenditure,and the correlation between fiscal expenditure decentralization and local government medical and health expenditure efficiency is higher.The level of education has a positive impact on the efficiency of local government health care expenditure;population density has a significant impact on the efficiency of local government health care expenditure in the eastern region;the level of urbanization has a significant negative impact on the efficiency of local government health care expenditure in the western region;per capita GDP has a negative impact on the efficiency of local government medical and health expenditure in the eastern and central regions,while it has a significant positive impact on the efficiency of local government medical and health expenditure in the western region.Finally,policy suggestions are put forward from four aspects: adjusting the scale of local government medical and health expenditures,improving the management level of government medical and health expenditures,strengthening technological innovation and improving the fiscal decentralization system. |
