财政去中心化如何影响健康结果? 来自中国的证据
Chen Chen1,2, Meng Zheng1,2, Junli Zhu1,2
1School of Public Health, Capital Medical University, Beijing, People's Republic of China.
Risk management and healthcare policy
|September 22, 2023
概括
财政去中心化对中国的健康结果产生了负面影响,改革未能改善政府的健康投资. 建议调整官方激励措施,并在评估中优先考虑健康.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
背景情况:
- 财政分散对健康结果的影响缺乏共识,特别是中国财政和税收制度改革后.
- 中国独特的财政去中心化需要对改革前后对健康结果的影响进行分析.
研究的目的:
- 分析财政去中心化对中国健康状况的影响.
- 评估这些影响在新一轮财政和税收制度改革之前和之后.
主要方法:
- 利用了来自中国卫生统计年鉴和统计年鉴的2007-2019年的面板数据.
- 使用SYS-GMM具有动态模型和滞后的解释变量来分析改革前后的影响.
- 应用汉森测试用于过度识别和AR(2) 在残留物中的序列相关性.
主要成果:
- 财政去中心化一直显示出对健康结果的负面影响.
- 政府的卫生支出没有调解财政去中心化与健康结果之间的关系.
- 财政去中心化对人均政府卫生支出在改革前有积极影响,但对改革后的支出份额有负面影响.
结论:
- 财政去中心化导致地方政府对中国公共福利和卫生投资的关注不足.
- 最近的财政和税收改革并没有改善政府卫生投资不足的情况.
- 建议包括调整地方官员的激励措施,将健康纳入绩效评估,优化支出结构,提高卫生支出效率.
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