Abstract
The efficiency of the local government health expenditure (GHE) in China determines the level of public health services. However, the local government does not pay much attention to that efficiency, though the scale of local GHE is increasing. In this paper, first, we use the data envelopment analysis (DEA) method to measure the static overall efficiency of the local government health expenditure (GHE) in each region of China from 2007 to 2016. Then, based on the spatial statistical theory, global and local spatial Moran’s I value is utilized to investigate its spatial correlation and spatial agglomeration phenomenon. Finally, the spatial spillover effect (SSE) of the static overall efficiency of local GHE in each region is measured by constructing a spatial Durbin model (SDM). It is demonstrated that there are significant differences in the efficiency of the local GHE between different regions of China. In addition, it is shown that Moran’s I value of the static overall efficiency of the local GHE from 2007 to 2016 is positive. It passed the test of the 5% significance level, indicating that there is a positive spatial correlation between the efficiency of the local GHE and a spatial spillover effect. On the other hand, the decomposition of the SDM reveals that the proportion of GHE to financial expenditure, gross domestic product (GDP) per capita, and population density have a positive effect on the efficiency of the local GHE. Hence, their growth will improve the GHE efficiency in the local region and neighboring regions. In contrast, the proportion of urban population, illiteracy, and fiscal decentralization have a negative effect. Thus, their growth will decrease the GHE efficiency in the local region and neighboring regions. The results are discussed and suggestions are given based on the analysis in this paper. The main contribution of this work is to consider the spatial spillover effect in terms with realistic meaning. The results obtained can be used as a reference for optimizing the structure and improving the efficiency of government health inputs. It breaks the government’s GDP-only theory-based assessment system and helps to improve it by assessing the GHE efficiency.
Highlights
For a long time, China has been committed to building an efficient and sustainable social public health system (SPHS)
The decomposition of the spatial Durbin model (SDM) reveals that the proportion of government health expenditure (GHE) to financial expenditure, gross domestic product (GDP) per capita, and population density have a positive effect on the efficiency of the local GHE
Guan et al (2014) used the data envelopment analysis (DEA) four-stage analysis framework to measure the efficiency of the social public healthcare input in 30 provinces in China and the results show that the provincial social public health expenditure has an annual efficiency loss of 29.5% [11]
Summary
China has been committed to building an efficient and sustainable social public health system (SPHS). Relevant policies are proposed by the government to improve efficiency and sustainability. Lots of science founding are established to make a substantial contribution to the improvement of public health. We know that the efficiency of government health expenditure (GHE) and healthcare sustainability can affect each other. The current Chinese medical and health services cannot meet the new requirements, that is, the people’s growing demand for healthcare, the high quality of health services, and the wide coverage of the medical insurance. It is very difficult to achieve the goal of an equal and sustainable healthcare service. It is important to study the GHE efficiency
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