ArticleBMC health services research2026
Spatiotemporal characteristics of health expenditure in mainland China during 2012-2020.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aims to examine the spatiotemporal characteristics of China’s total health expenditure structure from 2012 to 2020, and to observe the healthcare economic burden on the population in urban and rural areas across different provinces.
methodsThe data were obtained from the China Health Statistics Yearbook, the China Statistical Yearbook, and publicly available statistical data from various provinces, autonomous regions, and municipalities from 2012 to 2020. Joinpoint regression was employed to investigate the temporal trends of the three financing sources of total health expenditure (THE) and the total expenditure on health as percentage of gross domestic product (GDP). The elasticity coefficient of health consumption was calculated to measure whether there is a correlation between the growth of the health sector and that of the national economy. Furthermore, the global and local Moran’s I indices were used to examine the spatial characteristics of THE and its three financing sources in China from 2012 to 2020. A descriptive analysis was conducted to explore the characteristics of the healthcare economic burden in China and its provinces.
resultsFrom 2012 to 2022, China’s THE increased from 2,811.9 billion yuan to 7,217.5 billion yuan. The total expenditure on health as percentage of GDP exhibited a consistent upward trajectory, rising from 5.41% in 2012 to 7.12% by 2020. Over the past nine years, there has been a significant positive spatial autocorrelation in the total expenditure on health as a percentage of GDP, government health expenditure, and social health expenditure (Moran’s I > 0, P < 0.05). The Local Indicators of Spatial Association (LISA) cluster maps differ across these indicators. A consistent pattern emerged whereby urban populations spent significantly more annually on healthcare than rural populations. However, by 2020, this disparity had narrowed to 34.72%. Per capita medical care expenditure as a share of living expenditure of rural residents increased annually, reaching a threshold of 10% in 18 provinces by 2020. In contrast, urban areas remained below the 8% threshold.
conclusionSince 2012, China has consistently deepened its healthcare system reform, markedly increasing government investment in healthcare, particularly in impoverished areas, with the objective of achieving universal health coverage. Nevertheless, the economic burden of healthcare remains considerable for rural and underdeveloped populations. Furthermore, due to the dual factors of population aging and economic development levels, China’s THE will continue to face substantial financial pressure.
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