Population mobility : spatial spillover effect of government health expenditure in China

ABSTRACT

Background

Since the 20th century, pursuing Universal Health Coverage (UHC) has emerged as an important developmental objective in numerous countries and across the global health community. With the intricate ramifications of population mobility (PM), the government faces a mounting imperative to judiciously deploy health expenditure to realise UHC effectively.

Objective

This study aimed to construct a comprehensive UHC index for China, assess the spatial effects of Government Health Expenditure (GHE) on UHC, and explore the moderating effects of PM on this association.

Method

A Dynamic Spatial Durbin Model (DSDM) was employed to investigate the influence of the GHE on UHC. Therefore, we tested the moderating effect of PM.

Results

In the short-term, the GHE negatively impacted local UHC. However, it enhanced the UHC in neighbouring regions. Over the long term, GHE improved local UHC but decreased UHC in neighbouring regions. In the short-term, when the PM exceeded 1.42, the GHE increased the local UHC. Over the long term, when the PM exceeded 1.107, the GHE impeded local UHC. If the PM exceeded 0.91 in the long term, the GHE promoted UHC in neighbouring regions. The results of this study offer a partial explanation of GHE decisions and behaviours.

Conclusions

To enhance UHC, a viable strategy involves augmenting vertical transfer payments from the central government to local governments. Local governments should institute healthcare systems tailored to the urban scale and developmental stages, with due consideration for PM. Optimising the information disclosure mechanism is also a worthwhile endeavour.

KEYWORDS:

• Government health expenditure (GHE)
• universal health coverage (UHC)
• dynamic spatial durbin model
• population mobility
• spatial spillover effect

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Acknowledgments

The authors acknowledge the data support from the National Bureau of Statistics of China.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Mengying Wang conceived the idea. Simin Wan and Mengying Wang analysed the data and drafted the manuscript. All authors have read and agreed to the manuscript.

Data deposition

The data that support this study are available in public databases at https://www.stats.gov.cn/english/

Paper context

• The authors confirmed the dynamic spatial impact of Government Health Expenditure on Universal Health Coverage.

• Population mobility played a moderating role in the effect of Government Health Expenditure on Universal Health Coverage.

• The national government should implement vertical transfer, and local governments should institute healthcare systems commensurate with the scale and developmental stage to promote Universal Health Coverage and improve public health.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2024.2319952.

Additional information

Funding

The work was supported by the Special Project of the National Social Science Foundation of China under Grant No. [20ATJ003]; National Social Science Fund Project Major Bidding under Grant No. 21&ZD150; Jiangxi Provincial Department of Education Science and Technology Project under Grant No. [GJJ210546]; Jiangxi Provincial Social Science Foundation Youth Project under Grant No. [23YJ23].