Evaluation of the Results of China’s Fiscal Medical and Health Expenditure

Wang, Bin; Wang, Xiuzhi

doi:10.2147/rmhp.s377378

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…In addition, it is worth noting that the most previous studies have concluded that government health expenditure positively affects healthcare efficiency ( 18 ), but our findings yield the opposite conclusion. This may be for the following two reasons: First, there are pronounced regional differences in Chinese government health expenditure ( 76 ), with an overall tendency to favor regions with higher economic levels ( 77 ), and given regional disparities in economic development, government health expenditure has had other impacts on PHC institutions of various regions. Second, COVID-19 has posed a significant challenge to the PHC system ( 10 , 78 ), and efficiency must be improved despite the continuous increase in government investment in health.…”

Section: Discussionmentioning

confidence: 99%

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model

Huang,

Li,

Shi

et al. 2024

Front. Public Health

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IntroductionEnhancing the efficiency of primary healthcare services is essential for a populous and developing nation like China. This study offers a systematic analysis of the efficiency and spatial distribution of primary healthcare services in China. It elucidates the fundamental landscape and regional variances in efficiency, thereby furnishing a scientific foundation for enhancing service efficiency and fostering coordinated regional development.MethodsEmploys a three-stage DEA-Malmquist model to assess the efficiency of primary healthcare services across 31 provincial units in mainland China from 2012 to 2020. Additionally, it examines the spatial correlation of efficiency distribution using the Moran Index.ResultsThe efficiency of primary healthcare services in China is generally suboptimal with a noticeable declining trend, highlighting significant potential for improvement in both pure technical efficiency and scale efficiency. There is a pronounced efficiency gap among provinces, yet a positive spatial correlation is evident. Regionally, efficiency ranks in the order of East > Central > West. Factors such as GDP per capita and population density positively influence efficiency enhancements, while urbanization levels and government health expenditures appear to have a detrimental impact.DiscussionThe application of the three-stage DEA-Malmquist model and the Moran Index not only expands the methodological framework for researching primary healthcare service efficiency but also provides scientifically valuable insights for enhancing the efficiency of primary healthcare services in China and other developing nations.

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Section: Discussionmentioning

confidence: 99%

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model

Huang,

Li,

Shi

et al. 2024

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Academic research on fiscal expenditure efficiency has become more mature, while aging-related research has focused on livelihoods. Studies have found that fiscal expenditure efficiency is generally better in the eastern and central regions of China than in western ones [41][42][43]; social security expenditure efficiency varies significantly between regions [44]; healthcare expenditure efficiency values are generally on the rise [45]; healthcare expenditure efficiency is generally higher in the central, western, and northeastern regions than in eastern ones [46]; and the fiscal expenditure efficiency of basic public services, including education, healthcare, and social security, has a clear trend of convergence within each region [47].…”

Section: Introductionmentioning

confidence: 99%

Fiscal Expenditure Efficiency Measurement and Its Convergence Analysis on Aging Undertakings in China: Based on a Global Super-Efficiency Slacks-Based Measure Model

Zhao

Zhang

2023

Sustainability

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As the aging of China’s population continues to intensify as well as deepen, and fiscal support continues to increase, improving the efficiency of fiscal expenditure on aging undertakings has become the key to actively responding to the national strategy of sustainable population aging. This paper uses a global super-efficiency slacks-based measure model to measure the efficiency of fiscal expenditure on aging undertakings in China from 2011 to 2020. The results show, firstly, that the efficiency values are generally increasing. The eastern region’s fiscal expenditure efficiency has output deficiencies overall; all western, central, except Anhui, and northeast, except Jilin, provinces have input redundancies and output shortages. Secondly, the relatively effective provinces in terms of aging undertakings are mainly concentrated in the eastern coastal region; the number of effective provinces in the northeast is gradually increasing. Thirdly, excluding the eastern region, the efficiency values for all regions show a convergence trend; when controlling for region-specific influencing factors, the efficiency values of each region will converge to their respective steady-state levels. It is concluded that the trend in the fiscal management of aging undertakings in China is positive, and the levels of fiscal management as well as technology are higher in the east, lower in the west, less stable in the central, and more progressive in the northeast.

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The impact of basic health insurance participation characteristics on the health of mobile populations: the mediating role of health service utilization behavior

Dong

2024

Front. Public Health

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ObjectivesIt is a pivotal element of China’s health system reform to improve the health security of health insurance for the mobile population. Achieving this objective is integral to the success of the reform. The aim of this study was to analyze the impact of different enrollment characteristics of basic health insurance on the health of the mobile population and to investigate the mediating role of health service utilization behavior.MethodsThis cross-sectional study included 135,372 migrants who participated in the 2018 China Migrants Dynamic Survey (CMDS). Two indicators were employed in this study to assess the characteristics of the mobile population’s involvement in basic health insurance–namely, whether or not they participated in local health insurance and the type of health insurance in which they participated. The health status of the mobile population was measured using self-assessed health. Health service utilization behavior was divided into public health service utilization and medical service utilization. Multivariate ordered logistic regression was employed to examine the effect of health insurance on the health of the mobile population. Subsequently, the Bootstrap method was applied to analyze the mediating effect of health service utilization behavior in the relationship between health insurance and the health of the mobile population.ResultsHealth insurance had a positive impact on health, public health services, and health service utilization among the mobile population. However, enrollment in local health insurance (OR = 1.088, 95% CI = 1.043–1.134) and enrollment in Basic Medical Insurance for Urban Employees (OR = 1.178, 95% CI = 1.090–1.273) were more likely to be associated with higher levels of health and a greater likelihood of receiving health service utilization. The results of the mediating mechanism analysis indicated that health education, health records, family doctor contracting, receiving inpatient services, and being hospitalized locally all played a partially mediating role in the impact of the place of enrollment on health. Regarding the effect of the type of enrollment on health, three types of services–namely, health education, health records, and contracting with a family doctor–played a partially mediating role, while receiving inpatient services and being hospitalized locally did not exhibit a mediating effect. The effect of the type of participation on health is partially mediated.ConclusionBased on the impact of the different enrolment characteristics of basic health insurance on the health of the mobile population and the mediating role of health service utilization in this impact, furthermore, improvement of health insurance coverage for the mobile population should focus on improving the accessibility of health services, increasing the level of health insurance coverage, mitigating differences in treatment between the different insurance systems, and simplifying the process of transferring the health insurance relationships.

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Evaluation of the Results of China’s Fiscal Medical and Health Expenditure

Cited by 3 publications

References 18 publications

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model

Fiscal Expenditure Efficiency Measurement and Its Convergence Analysis on Aging Undertakings in China: Based on a Global Super-Efficiency Slacks-Based Measure Model

The impact of basic health insurance participation characteristics on the health of mobile populations: the mediating role of health service utilization behavior

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