Measurement and Causal Analysis of Regional Differences in Health Expenditure in China

Corresponding author: Zhu Yao, 294108671@qq.com

DOI: 10.12201/bmr.202608.00035

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  Abstract: Objective: To conduct an empirical study on the measurement and causes of regional differences in China''s health expenditure using panel data from 31 provinces and cities in China from 2009 to 2023.Methods: Inequality index method and Shapley value decomposition method based on regression equations. Results: (1)There are significant regional differences in per capita health expenditure among China''s provincial units, and these differences generally exhibit a fluctuating downward trend over time. (2)At the national level, the level of economic development reflected by per capita gross regional domestic product (GDP) is the most influencing factor contributing to regional differences in per capita health expenditure, with an average contribution of 43.98%; the number of health technicians per 10,000 people (25.59%) and urbanization rate (14.99%) rank second and third, respectively;and the number of hospital beds per 10,000 people (8.74%) and aging rate (6.69%)also contribute to regional differences in per capita health expenditure.(3)From a regional perspective, per capita GDP contributes the most to regional differences in per capita health expenditure in the eastern, central, and western regions; the final important influencing factor in the northeast region is the number of hospital beds per 10,000 people.Conclusions: It is recommended to optimize the structure, narrow the regional equity gap, tailor measures to local conditions, promote targeted policies in different regions, and foster collaborative development through joint construction and sharing.

  Key words: health expenditure；regional disparity；influencing factors；decomposition method of shapley value

  Submit time: 17 August 2026

  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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