什么样的政府卫生投入方式有利于城乡健康公平

What types of government health investment methods are beneficial to equity in urban and rural health?

本文基于Grossman健康需求理论,利用2007–2020年省级面板数据,研究了政府卫生投入的“补供方”和“补需方”方式以及二者组合,对城乡健康公平的影响,从而回答了何种卫生投入有利于城乡健康公平这一问题.结果表明:第一,总体上看,在研究期间,单一的投入方式无论是“补供方”还是“补需方”对城乡健康公平的作用都是负向的,两者需要一定条件相互协调才能有利于城乡健康公平;第二,具体来看,“补供方”降低了健康服务公平以及健康投入公平;“补需方”提高了健康状况公平,但是降低健康投入公平;第三,从二者的组合方式看,当“补供方”与“补需方”比例小于0.6586时,能显著提高城乡健康公平;第四,政府投入方式对城乡健康公平的影响程度受相关条件约束:当一个地区的年人均GDP较高时或者当医疗市场处于低供给、高需求时,“补供方”对城乡健康公平的不利影响减弱,“补需方”对城乡健康公平的不利影响增强.基于以上研究,提出了转换和优化政府卫生投入方式,促进城乡健康公平的政策建议.

Drawing on Grossman's health demand theory,this paper utilizes provincial panel data from 2007 to 2020 to study the impact of government health investment through both“supply-side supplementation” and “demand-side supplementation”,as well as their combination,on urban-rural health equity.This addresses the question of what type of health investment promotes urban-rural health equity.The findings are as follows:First,overall,during the study period,either mode of investment alone,whether supply-side or demand-side,negatively affects urban-rural health equity,requiring a certain degree of coordination between the two to be beneficial.Second,specifically,supply-side supplementation reduces equity in health services and health investments,while demand-side supplementation improves health status equity but reduces health investment equity.Third,in terms of their combination,a ratio of supply-side to demand-side supplementation lower than 0.6586 significantly enhances urban-rural health equity.Fourth,the degree to which government investment methods affect urban-rural health equity is contingent on specific conditions:In regions with higher per capita GDP or where the healthcare market is characterized by low supply and high demand,the adverse impact of supply-side supplementation on urban-rural health equity diminishes,while the adverse impact of demand-side supplementation intensifies.Based on these findings,policy recommendations are proposed to transform and optimize government health investments to promote urban-rural health equity.