Li Jixia, Xu Mengzhi, Liu Tengfei, Zhang Can
School of Government, Beijing Normal University, Beijing 100875, China.
School of Business Administration, The Open University of China, Beijing 100039, China.
Healthcare (Basel). 2023 May 17;11(10):1459. doi: 10.3390/healthcare11101459.
People's health is a necessary condition for the country's prosperity. Under the background of the COVID-19 pandemic and frequent natural disasters, exploring the spatial and temporal distribution, regional differences and convergence of China's provincial public health level is of great significance to promoting the coordinated development of China's regional public health and achieving the strategic goal of a "healthy China". Based on China's provincial panel data from 2009 to 2020, this paper constructs an evaluation index system for China's public health level from five dimensions: the popularization of a healthy life, optimization of health services, improvement of health insurance, construction of a healthy environment, and development of a health industry. In this paper, the entropy method, Dagum Gini coefficient, Kernel density function and spatial econometric model are used to analyze the spatiotemporal distribution, regional differences, dynamic evolution and convergence of China's public health level since the new medical reform. The study found that, first, China's public health level is generally low, structural contradictions are prominent and the construction of a healthy environment has become a shortcoming hindering the improvement of China's public health level since the new medical reform. The public health level of the four major regions showed a spatial distribution pattern of "high in the eastern, low in the northeastern, central and western" areas. Second, the overall Gini coefficient of China's public health level showed a "V-shaped" trend of first decreasing and then rising, but the overall decrease was greater than the increase, among which the regional difference was the main source of regional differences in China's public health level, but its contribution rate showed a downward trend. Third, except for the basic maintenance of a healthy environment, the Kernel density curves of China's public health level and its sub-dimensions have shifted to the right to a certain extent, and there is no polarization phenomenon. Finally, the level of public health in China has a significant spatial correlation. Except for the northeast region, the growth rate of low-level public health provinces in China and the other three major regions is higher than that of high-level public health provinces, showing a certain convergence trend. In addition, the impact of economic development, financial pressure, and urbanization on the convergence of public health levels in the four major regions is significantly heterogeneous.
人民健康是国家繁荣的必要条件。在新冠疫情大流行和自然灾害频发的背景下,探究中国省级公共卫生水平的时空分布、区域差异及收敛性,对于推动中国区域公共卫生协调发展、实现“健康中国”战略目标具有重要意义。基于2009—2020年中国省级面板数据,本文从健康生活普及、健康服务优化、健康保险完善、健康环境建设、健康产业发展五个维度构建中国公共卫生水平评价指标体系。运用熵值法、达古姆基尼系数、核密度函数和空间计量模型,分析新医改以来中国公共卫生水平的时空分布、区域差异、动态演进及收敛性。研究发现,一是中国公共卫生水平整体偏低,结构矛盾突出,健康环境建设成为新医改以来制约中国公共卫生水平提升的短板,四大区域公共卫生水平呈现“东部高、东北及中西部低”的空间分布格局;二是中国公共卫生水平总体基尼系数呈先下降后上升的“V”形走势,但总体下降幅度大于上升幅度,其中区域内差异是中国公共卫生水平地区差异的主要来源,但其贡献率呈下降趋势;三是除健康环境基本维持外,中国公共卫生水平及其子维度的核密度曲线均有一定程度的右移,不存在两极分化现象;四是中国公共卫生水平具有显著的空间相关性,除东北地区外,中国低水平公共卫生省份与其他三大区域的增长速度高于高水平公共卫生省份,呈现一定的收敛趋势,此外,经济发展、财政压力和城镇化对四大区域公共卫生水平收敛性的影响存在显著异质性。