智慧城市建设能否提升医疗卫生服务均等化水平——基于需求不确定性视角下的准自然实验

Could the Construction of Smart Cities Improve the Equalization of Medical and Health Services一-A Quasi-natural Experiment Based on Demand Uncertainty

本文以2003~2018年我国284个地级市层面的面板数据为样本,以智慧城市试点政策作为一项准自然实验,通过多期双重差分模型,并配合倾向得分匹配法分析需求不确定性下智慧城市建设对医疗卫生服务均等化的直接影响与间接传导,并从数字鸿沟和政府财政支出角度进行拓展分析,最后进行异质性分析。结果显示,智慧城市建设显著提升了医疗卫生服务均等化水平。更详细地,机制检验表明智慧城市建设主要通过基于供给侧的技术创新和需求侧的互联网使用率来降低居民医疗需求不确定性,促进有效需求与供给动态均衡,以提升医疗卫生服务均等化水平。进一步研究发现,当城市等级较低时,智慧城市建设有助于发挥其对医疗卫生服务均等化的提升作用;当城市处于沿海地区时,智慧城市建设有助于催生其对医疗卫生服务均等化的提升作用;当城市拥有的较多人力资本时,智慧城市建设有助于发挥其对医疗卫生服务均等化的规模报酬递增效应。研究结果为深化推进智慧城市试点政策,以数字经济推动医疗卫生服务均等化水平提升提供有益的政策启发。

Based on the panel data of 284 prefecture-level eities in China from 2003 to 2018,this paper takes smart city pilot policies as a quasi-natural experiment,uses a multi-period difference-in-difference model and propensity score matching method to analyze the direct impact and indirect transmission of smart cities construction on the equalization of medical and health services.And from the perspective of digital divide and government fiscal expenditure,this pa-per makes an expandable analysis,and finally does a heterogeneity analysis.The results show that the construction of smart cities has significantly improved the level of equality of medical and health services.In more detail,the mechanism test shows that the construction of smart cit-ies mainly improves the level of equality of medical and health services and lowers the demand uncertainty through technological innovation based on the supply side and internet popularization based on the demand side to promote dynamic equilibrium between effctive demand and sup-ply.Further research shows that cities with lower grades,coastal areas,and more human capital contribute to the increasing returns to scale effect of smart cities construction on the equalization of medical and health services.The research results provide valuable policy inspiration for deep-ening the smart city pilot policy and improving the equalization level of medical and health serv-ices driven by digital economy.