政府卫生支出规模对居民健康的影响研究

The Relationship between Specific Mortality and Public Health Expenditure:A Panel Threshold Analysis of 30 Provinces in China,2001-2017

医疗卫生体制改革以来,中国政府卫生支出快速增长。本文利用2001-2017年中国30个省(市、自治区)的面板数据,深入分析政府卫生支出规模与两项居民健康指标——孕产妇死亡率和围产儿死亡率之间的关系。研究结果表明:一是政府卫生支出规模的扩大能显著提高居民健康水平;二是政府卫生支出对于孕产妇死亡率的影响依西部、中部、东部的顺序递减,而围产儿死亡率的降低对于医疗卫生技术的依赖较大,对该指标的影响仅在东部地区显著;三是政府卫生支出规模存在门槛值,当政府卫生支出超过221.4亿元时,政府卫生支出的边际效应递增,而当政府卫生支出低于该水平时,可以通过提高女性的教育水平以及城市化水平来有效促进居民健康水平的提升。

In this paper,we revisit the issue of the effect of public health expenditure on the health outcome during the new health-care reform in China.Based on the panel data about 30 provinces in China from 2001 to 2017,a health production function was established.This study adopts panel model and threshold model to analysis the linear and nonlinear effects between health expenditure and specific mortalities.The results show that:(1)the impact of public health spending on decreasing maternal mortality and perinatal infant mortality are statistically significant;(2)Further group estimation and robustness tests show that the effect of public health expenditure on maternal mortality decreases from west to central and to east China,and it only has significant effect in east China on perinatal infant mortality;(3)Public health expenditure has threshold effect on maternal mortality and perinatal infant mortality,and China has not meet the perfect scale of public health expenditure,the government need to extend the expenditure in the health department and make health programs and services more effective.