Abstract:

Based on the urban administrative hierarchy and the heterogeneity of economic regions, this paper conducts research on the scale and quality effects of the local financial and health investment on the supply of urban medical and public services. Results of the empirical tests are as follows: (1) The local financial health input significantly improves both the supply and the demand of urban public health services in terms of the scale and the quality through the development of the local economy and the improvement of the efficiency of medical input and output; (2) When the administrative hierarchy of cities and the heterogeneity of economic regions are introduced, the local financial health investment shows a significant feature of “helping the disadvantaged”, and both the low-level urban agglomerations and the urban agglomerations in economically underdeveloped regions show a tendency of “scale effect prevailing”, and solve the problem of mismatch of resources in the medical and health field according to the logic of “quantitative change causing qualitative change”; (3) In the current situation where the supply and the demand of medical and public services in China are severely misaligned, the local fiscal and health investment is still at the “increasing marginal effect” stage, but the existence of the “ceiling” effect of the active fiscal policy should not be ignored; (4) Unexpected public health incidents cannot quickly improve the ability to respond to urban public health crises, but the timely increase of the local fiscal health investment can effectively reduce the response time lag.

Key words: Local Financial Health Input, Urban Medical and Public Services, Scale Effect, Quality Effect

摘要：

本文基于城市行政等级与经济区域异质性,围绕地方财政卫生投入对城市医疗卫生公共服务供给规模效应与质量效应展开研究。实证检验发现:(1)地方财政卫生投入通过发展地方经济和提升医疗卫生投入产出效能两个渠道,从规模和质量层面显著改善城市医疗卫生公共服务供求状况;(2)地方财政卫生投入具有显著的“帮扶弱者”特征,低行政等级城市群和经济欠发达区域城市群均表现出规模效应占优的态势,按照“量变引起质变”的逻辑解决医疗卫生领域资源错配问题;(3)在当前我国医疗卫生公共服务供求错位较为严重的背景下,地方财政卫生投入仍处于“边际效应递增”阶段,但也不应忽视积极财政政策“天花板”的存在性;(4)突发性公共卫生事件并不能够迅速改善城市公共卫生危机应对能力,但及时增强地方财政卫生投入力度能够有效缩短反应时滞。

关键词: 地方财政卫生投入, 城市医疗卫生公共服务, 规模效应, 质量效应