Intra-provincial fiscal decentralisation, relative wealth and healthcare efficiency: empirical evidence from China

Sun, Shuo and Andrews, Rhys ORCID: https://orcid.org/0000-0003-1904-9819 2023. Intra-provincial fiscal decentralisation, relative wealth and healthcare efficiency: empirical evidence from China. Public Administration 101 (3) , pp. 973-992. 10.1111/padm.12832

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Abstract

Decentralizing fiscal power to locally elected governments is often regarded as beneficial for public service efficiency. However, questions remain about whether decentralizing fiscal responsibilities work well in countries lacking political decentralization. In China, fiscal decentralization has significantly strengthened the role of local governments in the provision of healthcare services, but evidence of its efficiency effects is scarce. To cast light on this issue, this study investigates the relationship between intra-provincial fiscal decentralization and the productive efficiency of healthcare services in China. Analysis of panel data for 2006–2017 suggests that expenditure and revenue decentralization from provincial to sub-provincial governments significantly improves healthcare efficiency. Further analysis suggests that the positive impact of healthcare expenditure decentralization on healthcare efficiency may be stronger in wealthier provinces. These findings have important theoretical and practical implications.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Business (Including Economics)
Publisher:	Wiley
ISSN:	0033-3298
Date of First Compliant Deposit:	17 January 2022
Date of Acceptance:	17 January 2022
Last Modified:	16 Mar 2025 15:15
URI:	https://orca.cardiff.ac.uk/id/eprint/146740

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