The Status Quo of Financial Investment in National Essential Public Health Services Programs and Its Dual Decomposition of Equalization

Corresponding author: YANG Li, lyang@bjmu.edu.cn

DOI: 10.12201/bmr.202506.00001

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  Abstract: Promoting the equalization of essential public health services is an explicit requirement for deepening the healthcare system reform and an important fundamental measure to achieve the strategic goals of Healthy China 2030. Sufficient, fair, efficient, and sustainable financing guarantees are the preconditions for realizing the equalization of essential public health services. In this study, the Gini coefficient decomposed by region (Dagum’ Gini) and the Gini coefficient decomposed by source were adopted to measure the degree of equalization of the per capita expenditure on essential public health services nationwide and its evolution trend, and to conduct a dual decomposition of the contribution rate and marginal contribution rate of financial investments from different regions and sources. The study found that over the past 15 years, the scale of financial investment in essential public health services has grown rapidly, and the scale and growth rate of central government financial investment are both higher than those of local governments. The degree of equalization of financial investment in essential public health services nationwide has significantly improved, among which the contribution rate of interregional differences is the largest. Whether in terms of absolute contribution or marginal contribution, central government transfer payments play an increasingly important and positive role in promoting the equalization of financial investment in essential public health services nationwide. It is recommended to attach great importance to the sustainability of financial investment in essential public health services, and establish a long-term financing guarantee system and a mechanism for the growth of financial investment; to dynamically optimize the distribution structure of financial investment in essential public health services, and further improve the equalization adjustment effect of central government transfer payments; to strengthen the cost management of new essential public health service items, and improve the performance assessment mechanism oriented towards health outcomes; and to explore the reasonable overall use of funds for essential public health services and other funds to form an incentive and restraint mechanism conducive to the integration of treatment and prevention.

  Key words: Essential public health services; Financial investment; Central government transfer payments; Equalization; Decomposition of the Gini coefficient

  Submit time: 3 June 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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