财政分权、公共部门效率与医疗卫生服务供给

发布时间：2018-06-09 19:52

本文选题：财政分权 + 公共部门效率　；参考：《财经研究》2015年05期

【摘要】：文章基于财政分权与公共部门效率间关系在我国仍未引起足够重视以及国外相关研究尚不成熟的现实背景,首先从理论层面构建财政分权与公共部门效率之间倒"U"形关系的理论框架;然后在构建财政分权组合指标体系的基础上,运用三种组合指标预测方法和Shannon-Spearman方法对中国式财政分权水平重新进行测度;并将公共部门提供公共服务的全要素生产率指数分解为技术效率指数与技术进步指数,以医疗卫生部门为例,采取Malmquist生产率指数方法全面测度我国地方政府医疗卫生服务供给的三种效率指数;最后选择以财政分权作为门限变量建立面板门限回归模型,实证检验财政分权与医疗卫生服务供给之间是否存在倒"U"形关系。研究发现:(1)当财政分权位于第一和第二区域内,即分权水平小于0.5263时,财政分权水平的增加有利于医疗卫生服务供给效率的提升;但当财政分权从第一区制进入第二区域内,即分权水平位于0.3643与0.5263之间时,财政分权对医疗卫生服务供给效率的激励效应出现下降。(2)当财政分权进入第三区域内,即分权水平大于0.5263时,财政分权与医疗卫生服务供给效率之间负相关,即财政分权水平的提高反而不利于医疗卫生服务的供给。(3)财政分权与医疗卫生服务供给之间的倒"U"形关系主要是通过影响医疗卫生服务供给的技术进步实现的。
[Abstract]:This paper is based on the fact that the relationship between fiscal decentralization and public sector efficiency has not been paid enough attention to in China and that the relevant research abroad is still immature. First of all, the theoretical framework of the inverted "U" relationship between fiscal decentralization and public sector efficiency is constructed from the theoretical level, and then, on the basis of constructing the index system of fiscal decentralization combination, This paper uses three combined index forecasting methods and Shannon-Spearman method to re-measure the level of fiscal decentralization in China, and decomposes the total factor productivity index of public service delivery into technology efficiency index and technological progress index. Taking the medical and health department as an example, the Malmquist productivity index method is adopted to measure the three efficiency indices of local government medical and health service supply in our country. Finally, we choose fiscal decentralization as the threshold variable to establish the panel threshold regression model. Whether there is an inverted U-shape relationship between fiscal decentralization and the supply of medical and health services. It is found that when fiscal decentralization is located in the first and second regions, that is, when the level of decentralization is less than 0.5263, the increase of fiscal decentralization is beneficial to the improvement of the efficiency of medical and health services supply, but when fiscal decentralization moves from the first district system to the second region, That is, when the decentralization level is between 0.3643 and 0.5263, the incentive effect of fiscal decentralization on the efficiency of medical and health service supply decreases. (2) when fiscal decentralization enters the third region, that is, the decentralization level is greater than 0.5263. There is a negative correlation between fiscal decentralization and the efficiency of medical and health service supply. That is, the improvement of the level of fiscal decentralization is not conducive to the supply of medical and health services. (3) the inverted "U" relationship between fiscal decentralization and the supply of medical and health services is mainly realized through the technological progress affecting the supply of medical and health services.
【作者单位】：安徽财经大学财政与公共管理学院;东北财经大学数学与数量经济学院;
【基金】：国家社会科学基金项目(10CJY016) 安徽省自然科学基金面上项目(1508085MG139)
【分类号】：R197.1;F812.2

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