Abstract
ObjectiveWe aim to estimate the total factor productivity and analyze factors related to the Chinese government’s health care expenditure in each of its provinces after its implementation of new health care reform in the period after 2009.Materials and methodsWe use the Malmquist DEA model to measure efficiency and apply the Tobit regression to explore factors that influence the efficiency of government health care expenditure. Data are taken from the China statistics yearbook (2004–2020).ResultsWe find that the average TFP of China’s 31 provincial health care expenditure was lower than 1 in the period 2009–2019. We note that the average TFP was much higher after new health care reform was implemented, and note this in the eastern, central and western regions. But per capita GDP, population density and new health care reform implementation are found to have a statistically significant impact on the technical efficiency of the provincial government’s health care expenditure (P<0.05); meanwhile, region, education, urbanization and per capita provincial government health care expenditure are not found to have a statistically significant impact.ConclusionAlthough the implementation of the new medical reform has improved the efficiency of the government’s health expenditure, it is remains low in 31 provinces in China. In addition, the government should consider per capita GDP, population density and other factors when coordinating the allocation of health care input.SignificanceThis study systematically analyzes the efficiency and influencing factors of the Chinese government’s health expenditure after it introduced new health care reforms. The results show that China’s new medical reform will help to improve the government’s health expenditure. The Chinese government can continue to adhere to the new medical reform policy, and should pay attention to demographic and economic factors when implementing the policy.
Highlights
It is well known that health care institutions experienced many problems in China after the SARS outbreak in 2003, and that they affected the implementation of health care policy reform
We note that the average total factor productivity (TFP) was much higher after new health care reform was implemented, and note this in the eastern, central and western regions
The implementation of the new medical reform has improved the efficiency of the government’s health expenditure, it is remains low in 31 provinces in China
Summary
It is well known that health care institutions experienced many problems in China after the SARS outbreak in 2003, and that they affected the implementation of health care policy reform. China launched a new round of health care reform in 2009, which mainly sought to enhance the government’s leadership and increase health care investment. This medical reform program proposed that governments should increase their spending by 850 billion yuan to support medical and health care reform in 2009–2011. The Chinese government has increased its investment in health care, the country’s medical and health care service supply has been unable to meet rapidly growing demand, which has produced supply-demand imbalance, tensions between doctors and patients and rapidly rising medical costs [3]. The doctor-patient relationship has become more difficult
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