健康中国建设中“重医轻卫”对居民健康水平的影响研究——基于政府支出结构视角

贵州财经大学学报 ›› 2025 ›› Issue (01): 42-50.

• 宏观经济 • 上一篇

健康中国建设中“重医轻卫”对居民健康水平的影响研究——基于政府支出结构视角

庞瑞芝¹, 郑思源², 李倩楠²

1. 南开大学企业研究中心, 天津 300071;
2. 南开大学经济学院, 天津 300071

收稿日期:2023-11-05 发布日期:2025-02-25
作者简介:庞瑞芝(1973—),女,山东梁山人,博士,南开大学经济与社会发展研究院教授、博士生导师,南开大学企业研究中心主任,研究方向为产业组织、产业效率与大健康经济;郑思源(1999—),女,江西上饶人,南开大学经济学院博士研究生,研究方向为产业经济;李倩楠(1998—),女,山西晋城人,南开大学经济学院博士研究生,研究方向为产业经济。
基金资助:
国家社会科学基金重点项目“后疫情时代我国卫生资源结构性失衡考察与优化配置路径研究”(21AJY012)。

Research on the Impact of "Emphasizing Medical Care over Public Health" in Healthy China Development on Residents' Health Levels: Based on the Perspective of Government Expenditure Structure

PANG Ruizhi¹, ZHENG Siyuan², LI Qiannan²

1. Enterprise Research Center, Nankai University, Tianjin 300071, China;
2. School of Economics, Nankai University, Tianjin 300071, China

Received:2023-11-05 Published:2025-02-25

摘要/Abstract

摘要： 深入研究“重医轻卫”对居民健康水平的影响,对优化政府卫生支出结构、提升医疗卫生体系整体效能、推进健康中国战略建设具有重要的现实意义。在研究视角上,与现有文献关注于政府卫生支出总量不同,文章着重从政府支出结构视角,基于2013—2019年中国省级面板数据,通过双向固定效应模型检验了“重医轻卫”对居民健康水平的影响。结果显示:“重医轻卫”显著降低了居民健康水平,这一结论在使用系统GMM回归缓解内生性以及Tobit广义线性回归模型进行稳健性检验后仍然成立;“重医轻卫”对居民健康水平的影响具有区域异质性,东部和中部地区已经凸显,西部地区暂未显现。

关键词: 健康中国, 公共卫生, 政府卫生支出, 资源配置失衡, 居民健康水平

Abstract: In-depth research on the impact of "emphasizing medical care over public health" on residents' health levels is of great practical significance for optimizing structure of government health spending, enhancing the overall efficiency of the medical and health system, and promoting the construction of the Healthy China strategy. From the perspective of research, unlike the existing literature that focuses on the total amount of government health spending, this research focuses on the structure of government. Based on China's provincial panel data from 2013 to 2019, a two-way fixed effect model is used to examine the of "emphasizing medical care over public health" on residents' health levels. The results show that "emphasizing medical care over public health" has significantly reduced the health level of residents, and this conclusion still holds alleviating endogeneity using system GMM regression and conducting robustness tests using Tobit generalized linear regression model. The impact of "emphasizing medical care over public health" on residents' health levels has regional heterogeneity, which has already become prominent in eastern central regions, but has not yet appeared in western regions.

Key words: Healthy China, public health, government health expenditure, resource allocation imbalance, residents' health level

中图分类号:

F062.6

庞瑞芝, 郑思源, 李倩楠. 健康中国建设中“重医轻卫”对居民健康水平的影响研究——基于政府支出结构视角[J]. 贵州财经大学学报, 2025(01): 42-50.

PANG Ruizhi, ZHENG Siyuan, LI Qiannan. Research on the Impact of "Emphasizing Medical Care over Public Health" in Healthy China Development on Residents' Health Levels: Based on the Perspective of Government Expenditure Structure[J]. Journal of Guizhou University of Finance and Economics, 2025(01): 42-50.

参考文献

[1] 代英姿.医疗卫生需求与公共卫生支出[J].辽宁大学学报(哲学社会科学版),2005,33(4):128~134.
[2] 谢丹夏,赵魏一,刘培林,等.公共卫生体系改革的经济学分析——预防和治疗资源最优配置的机制与政策设计[J].经济学报,2024,11(2):377~408.
[3] 朱玲.健康投资与人力资本理论[J].经济学动态,2002(8):56~60.
[4] 方明珠,许国章.中国省市两级疾控机构创新转型发展的思考[J].中国公共卫生管理,2018,34(5):581~583.
[5] Deng F, Lv J H, Wang H L, et al. Expanding Public Health in China: An Empirical Analysis of Healthcare Inputs and Outputs[J]. Public Health, 2017, 142:73~84.
[6] Warner K E, Warner P A. Is an Ounce of Prevention Worth a Pound of Cure? Disease Prevention in Health Care Reform[J]. J Ambul Care Manage, 1993, 16(4):38~49.
[7] 刘吕吉,李桥.政府卫生支出城市偏向与中国城乡收入差距——理论分析与实证检验[J].贵州财经大学学报,2015(1):99-108.
[8] 徐建国,刘开泰,陈博文,等.建立新型国家预防医学体系战略研究[J].中国工程科学,2017,19(2):55~61.
[9] 朱坤,刘尚希,杨良初.新世纪中国卫生财政支出分析[J].财政科学,2022(1):5~15.
[10] 邓峰,吕菊红,高建民.中国医疗卫生服务领域供给侧改革分析[J].中国公共卫生管理,2017,33(4):448~451.
[11] 陈文辉.论医疗卫生的公共产品特性及其实现形式[J].宁波大学学报(理工版),2007,20(2):268~273.
[12] Heffley D R. Allocating Health Expenditures to Treatment and Prevention[J]. Journal of Health Economics, 1982, 1(3):265~290.
[13] Bekker-Grob E W, Polder J J, Mackenbach J P, et al. Towards a Comprehensive Estimate of National Spending on Prevention[J]. BMC Public Health, 2007, 7(1):252.
[14] Kamanda E, Lanpin Y, Sesay B. Causal Nexus between Health Expenditure, Health Outcome and Economic Growth: Empirical Evidence from Sub-Saharan Africa Countries[J]. Int J Health Plann Mgm, 2022, 37(4):2284~2302.
[15] Wang F. The Roles of Preventive and Curative Health Care in Economic Development[J]. PLoS One, 2018, 13(11):e0206808.
[16] Miller G, Daly M, Roehrig C. Trade Offs in Cardiovascular Disease Prevention,Treatment,and Research[J]. Health Care Management Science, 2013, 16(2):87~100.
[17] Wang F, Wang J D. Investing Preventive Care and Economic Development in Ageing Societies:Empirical Evidences from Oecd Countries[J]. Health Economics Review, 2021, 11(1):11~18.
[18] Wang F, Wang J D, Huang Y X. Health Expenditures Spent for Prevention,Economic Performance, and Social Welfare[J]. Health Economics Review, 2016, 6(1):45.
[19] 杨燕绥,妥宏武.卫生费用增长控制与医疗保障治理机制研究——基于全国与省际数据的实证分析[J].国家行政学院学报,2018(2):52~58.
[20] 熊先兰,姜林秀.卫生支出对传染性公共卫生突发事件防控效果的影响——基于省际面板的实证分析[J].湘潭大学学报:哲学社会科学版,2021,45(4):92~98.
[21] 陶春海,王玉晓.政府卫生支出结构对经济增长的影响——基于Lasso回归和面板门槛模型的分析[J].软科学,2018,32(11):34~38.
[22] 王树森,杨澄宇.卫生支出结构、个人健康投资与居民福利[J].经济研究,2023,58(6):190~208.
[23] Grossman M. On the concept of health capital and the demand for health[J]. Journal of Political Economy, 1972, 80(2):233~255.
[24] Kim K, Moody P M. More Resources Better Health? A Cross-National Perspective[J]. Social Science and Medicine, 1992, 34(8):837~842.
[25] Oladosu A O, Chanimbe T, Anaduaka U S. Effect of Public Health Expenditure on Health Outcomes in Nigeria and Ghana[J]. Health Policy OPEN, 2022, 3:100072.
[26] Arthur E,Oaikhenan H E. The Effects of Health Expenditure on Health Outcomes in Sub-Saharan Africa(SSA)[J]. African Development Review, 2017, 29(3):524~536.
[27] Onofrei M, Vatamanu A F, Vintil G, et al. Government Health Expenditure and Public Health Outcomes: A Comparative Study among Eu Developing Countries[J]. IJERPH, 2021, 18(20):10725.
[28] Bidani B, Ravallion M. Decomposing Social Indicators Using Distributional Data[J]. Journal of Econometrics, 1997, 77(4):125~139.
[29] 陈天祥,方敏.公共卫生支出、健康结果与卫生投入政策——基于189个国家和地区的面板门槛分析(1995—2011年)[J].浙江大学学报(人文社会科学版),2016(1):91~107.
[30] 徐慧枫,简文清,温湖炜.基于阈值面板数据模型的公共卫生支出健康效益研究[J].卫生经济研究,2017(1):61~64.
[31] 王屹亭,火煜雯,凤博.卫生服务准公共产品划分的依据与意义[J].医学与哲学:A,2015(11):52~55.
[32] 王秋颖,李昂,董怡然.基于医疗服务链的移动医疗App现状及问题分析[J].中国医院管理,2018,38(7):48~49.
[33] 陈其林,韩晓婷.准公共产品的性质:定义、分类依据及其类别[J].经济学家,2010(7):13~21.
[34] 任晓春,牛亚泽,孟令光.论公共卫生服务与基本医疗服务的协同之路[J].医学与哲学,2021,42(19):65~69.
[35] 毛文琳,卫龙宝.政府卫生支出规模对居民健康的影响研究[J].浙江社会科学,2020(3):11~20.
[36] 王杰杰,何辉.公共卫生支出是否提高了居民健康水平——基于宏观和微观数据的实证分析[J].财政监督,2018(21):72~78.
[37] 周焕,贺俊,刘亮亮.财政分权、城乡收入差距对居民健康水平影响的实证检验[J].统计与决策,2017(12):137~140.
[38] 赵雪雁,王伟军,万文玉.中国居民健康水平的区域差异:2003—2013[J].地理学报,2017,72(4):685~698.
[39] 杨应策,俞佳立,夏梦凡.居民健康水平与医疗卫生资源投入的协调度研究[J].统计与决策,2021(11):53~57.
[40] 张超,钟昌标,蒋天颖,等.我国区域协调发展时空分异及其影响因素[J].经济地理,2020(9):15~26.
[41] 宋敏,周鹏,司海涛.金融科技与企业全要素生产率——"赋能"和信贷配给的视角[J].中国工业经济,2021(4):138~155.

健康中国建设中“重医轻卫”对居民健康水平的影响研究——基于政府支出结构视角

Research on the Impact of "Emphasizing Medical Care over Public Health" in Healthy China Development on Residents' Health Levels: Based on the Perspective of Government Expenditure Structure

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