Guo Xuesong, Zhang Jun, Xu Zhiwei, Cong Xin, Zhu Zhenli
School of Public Policy and Administration of Xi'an Jiaotong University, Xi'an, Shanxi, China.
Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China.
PLoS One. 2021 Oct 13;16(10):e0258274. doi: 10.1371/journal.pone.0258274. eCollection 2021.
We aim to estimate the total factor productivity and analyze factors related to the Chinese government's health care expenditure in each of its provinces after its implementation of new health care reform in the period after 2009.
We use the Malmquist DEA model to measure efficiency and apply the Tobit regression to explore factors that influence the efficiency of government health care expenditure. Data are taken from the China statistics yearbook (2004-2020).
We find that the average TFP of China's 31 provincial health care expenditure was lower than 1 in the period 2009-2019. We note that the average TFP was much higher after new health care reform was implemented, and note this in the eastern, central and western regions. But per capita GDP, population density and new health care reform implementation are found to have a statistically significant impact on the technical efficiency of the provincial government's health care expenditure (P<0.05); meanwhile, region, education, urbanization and per capita provincial government health care expenditure are not found to have a statistically significant impact.
Although the implementation of the new medical reform has improved the efficiency of the government's health expenditure, it is remains low in 31 provinces in China. In addition, the government should consider per capita GDP, population density and other factors when coordinating the allocation of health care input.
This study systematically analyzes the efficiency and influencing factors of the Chinese government's health expenditure after it introduced new health care reforms. The results show that China's new medical reform will help to improve the government's health expenditure. The Chinese government can continue to adhere to the new medical reform policy, and should pay attention to demographic and economic factors when implementing the policy.
我们旨在估算全要素生产率，并分析2009年后中国新医改实施期间各省份政府医疗卫生支出的相关影响因素。
我们使用Malmquist DEA模型来衡量效率，并应用Tobit回归来探索影响政府医疗卫生支出效率的因素。数据取自《中国统计年鉴》（2004 - 2020年）。
我们发现，2009 - 2019年期间，中国31个省级医疗卫生支出的平均全要素生产率低于1。我们注意到，新医改实施后平均全要素生产率大幅提高，且东部、中部和西部地区均如此。但人均GDP、人口密度和新医改实施对省级政府医疗卫生支出的技术效率有统计学显著影响（P<0.05）；同时，地区、教育、城市化和省级政府人均医疗卫生支出未发现有统计学显著影响。
尽管新医改的实施提高了政府卫生支出的效率，但中国31个省份的效率仍然较低。此外，政府在协调医疗卫生投入分配时应考虑人均GDP、人口密度等因素。
本研究系统分析了中国政府在推行新医改后的卫生支出效率及影响因素。结果表明，中国的新医改将有助于提高政府卫生支出。中国政府可以继续坚持新医改政策，并在实施政策时关注人口和经济因素。
