School of Management, Shandong Second Medical University, Weifang, Shandong, China.
School of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
Front Public Health. 2024 Oct 1;12:1429006. doi: 10.3389/fpubh.2024.1429006. eCollection 2024.
System coordination is an effective way to achieve high-quality development, and the debate on the interaction between health investment and economic development is still ongoing. To strengthen previous research and offer feasible advice and references for relevant stakeholders, we provide empirical evidence for exploring intersystem coordination and enhancement pathways using data from China.
Based on the data published by the National Bureau of Statistics of China, the current status of the interaction and coordination between health investment and economic development in China was measured by calculating the comprehensive evaluation index, relative development degree, and coupling coordination degree. Subsequently, a fuzzy-set qualitative comparative analysis method was introduced to explore pathways for enhancing system interaction and coordination.
There are obvious inter-provincial and regional differences between health investment and economic development in China. Provinces in the west and north are lagging in economic development, while provinces in the east and south are lagging in health investment. There is a clear synergy between health investment and economic development, and there is still much room for improving the degree of coupling coordination between systems. The five conditional configurations derived from the fuzzy-set qualitative comparative analysis yield three pathways for enhancing system coordination: a health expenditure-driven path, an economic development-driven path, and a balanced health investment and economic development-driven path.
Health expenditure is sufficient for high coordination, and the level and equity of investment in health expenditure should be improved. The gross regional product is a necessary and sufficient condition for high coordination, and consideration must be given to strengthening the regional economic support capacity. Health investment and economic development can drive the coordinated development of the system in a balanced way. This enlightens us to give full play to the positive synergy between health investment and economic development based on promoting the benign interaction of subsystems.
系统协调是实现高质量发展的有效途径,健康投入与经济发展的相互作用仍存在争议。为了加强已有研究,并为相关利益攸关方提供可行的建议和参考,我们利用中国的数据提供了探索系统间协调和增强途径的经验证据。
基于中国国家统计局公布的数据,通过计算综合评价指数、相对发展程度和耦合协调度,衡量了中国健康投入与经济发展相互作用和协调的现状。随后,引入模糊集定性比较分析方法,探讨了增强系统相互作用和协调的途径。
中国的健康投入和经济发展在省际和地区间存在明显差异。西部和北部省份的经济发展滞后,而东部和南部省份的健康投入滞后。健康投入与经济发展之间存在明显的协同作用,系统耦合协调程度仍有很大的提升空间。模糊集定性比较分析得出的五个条件配置产生了三种增强系统协调的途径:卫生支出驱动路径、经济发展驱动路径和平衡的卫生投入与经济发展驱动路径。
充足的卫生支出可实现高度协调,应提高卫生支出的水平和公平性。地区生产总值是高度协调的必要和充分条件,必须考虑加强区域经济支持能力。卫生投入和经济发展可以以平衡的方式推动系统的协调发展。这启示我们,要在促进子系统良性互动的基础上,充分发挥卫生投入与经济发展之间的积极协同作用。