财税与公共管理学院知识库

在人类社会的经济发展历程中，人口老龄化是其中必经的阶段与不可逆转的趋势。预计在“十四五”期间，60岁及以上老年人口在我国的占比或将超过20%，进入到中度老龄化阶段。这种人口老龄化程度的加深会引致医疗卫生服务相关需求的变化，给财政医疗卫生支出的可持续性带来严峻挑战。基于中国所面临的这种人口老龄化加剧以及财政医疗卫生支出压力增大的背景，本文首先，对人口老龄化、财政医疗卫生支出、人口老龄化对财政医疗卫生支出的影响展开阐述目前学术界的研究情况，并介绍相关理论基础和概念界定；其次，分析了我国人口老龄化和财政医疗卫生支出的发展现状和研究假设，提出了三个假说；最后，采用2008-2020的中国分省面板数据，通过构建面板数据计量模型、门槛效应模型以及中介效应模型等，研究人口老龄化对于财政医疗卫生支出的具体影响，验证了本文提出的三个假说。

研究结果发现，第一，中国的人口老龄化及财政医疗卫生支出水平均呈现上升趋势，年均增长率分别达到了2.794%、17.554%；第二，在不同模型下，人口老龄化均对财政医疗卫生支出存在显著正向影响，说明人口老龄化程度加深会推动财政医疗卫生支出水平上升；第三，相较于低城乡收入差距水平，在高城乡收入差距水平下，人口老龄化对于财政医疗卫生支出的正向推动作用更为明显；第四，人口老龄化会通过经济发展水平间接影响到财政医疗卫生支出水平，经济发展水平在其中发挥一定的遮掩效应。研究结果启示政府应将更多地国家财政资金应用于民生领域，同时应通过加大财政投入力度以支持社会养老、医疗模式的创新性发展，以应对日益加深的老龄化水平。

In the course of economic development of human society, population aging is a necessary stage and irreversible trend. It is expected that during the "14th Five-Year Plan" period, the proportion of the aged population 60 and above in our country will exceed 20%, entering the stage of moderate aging. This deepening ageing of the population will lead to changes in the demand for health services, posing serious challenges to the sustainability of fiscal health expenditure. Based on the background of population aging and the increasing pressure of financial health expenditure in China, this paper firstly expounds the current research situation of the academic circle on population aging, financial health expenditure, and the impact of population aging on financial health expenditure, and introduces the relevant theoretical basis and concept definition. Secondly, it analyses the development status and hypothesis of Chinese population aging and financial health expenditure, and puts forward three hypotheses. Finally, by using the panel data of China by provinces from 2008 to 2020 and constructing the panel data econometric model, threshold effect model and intermediary effect model, this paper studies the specific impact of population aging on financial medical and health expenditure, and verifies the three hypotheses proposed in this paper.

The results show that, firstly, the population aging and the level of financial health expenditure in China are on the rise, with an average annual growth rate of 2.794% and 17.554% respectively; Secondly, under different models, population aging has a significant positive impact on financial health expenditure, indicating that the deepening of population aging will promote the level of financial health expenditure; Third, compared with the low level of urban-rural income gap, under the high level of urban-rural income gap, the positive role of population aging in promoting fiscal and medical expenditure is more obvious; Fourth, the aging population will indirectly affect the level of financial and medical expenditure through the level of economic development, and the level of economic development will play a certain masking effect in it. The research results enlighten the government to apply more national financial funds to people's livelihood, and at the same time, to support the innovative development of social pension and medical model by increasing financial input to cope with the deepening aging level.