Competition for Health: A New Mechanism for Improving the Efficiency of Health Service Provision——Empirical Evidence from Provincial Governments in China after the Reform of Medicine and Healthcare System

Corresponding author: Ji Naili

DOI: 10.12201/bmr.202311.00004

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  Abstract: Objective：This paper aims at analyzing the relationship between local government competition and the efficiency of healthcare service supply，and exploring the transmission paths，external environment，and stage fluctuations under the influence of third variables．Method：This paper utilizes multi-period panel data at the provincial level in China，relies on the DEA-Malmquist model to measure the efficiency of public health service supply，and investigates the impact of instrumental variable Tobit model．Conclusion：(1) Moderate competition for health can enhance the efficiency of healthcare service supply．(2) This promoting effect occurs through two pathways: the improvement of government financial control strength and the promotion of industrial structure transformation and upgrading．Moreover，it is enhanced with the improvement of the policy environment．(3) This promoting effect exhibits nonlinear characteristics, continuously strengthening with increasing fiscal revenue and urbanization levels, weakening with increased fiscal autonomy, and having a transient ineffective interval with population aggregation.

  Key words: Local Government Competition; Public Health Services; Supply Efficiency; New Medical Reform; Chinese-Style Decentralization

  Submit time: 20 November 2023

  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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