人口老龄化对医疗支出的影响

Theimpactofagingpopulationonmedicalexpenditure—empiricalstudybasedonprovincialpaneldataAbstractInrecentyears,thecontinuousimprovementofmedicalsystemsandtheadvancementoftechnologyrisepeople'slifeexpectancy.However,theconcomitantproblemofagingonmedicalexpensescannotbeignored.Inordertoexploretherelationshipbetweenagingandmedicalexpenses,thispaperusesprovincialpaneldatatoconductregressionanalysis.Theresultsshowedthattheaging,eldersupportratioandGDPpercapitaareallpositivelyrelatedtomedicalexpenses.Bycontrast,increasesinthenumberofmedicaltechniciansandintheurbanizationratetosomeextentcurbtheincreasingtrendofmedicalexpenditure.Conclusively,whenthegovernmenttriestocontrolthesegrowths,oneofthemosteffectivemeasuresistopromoteurban-ruralintegration.KeywordsAging;Medicalexpenditure;Urban-ruraldisparity1.IntroductionWiththerapiddevelopmentoftheeconomyandsociety,China'stotalhealthexpenditurehasgrownsharply.From1990to2010,theaverageannualgrowthratewas19%.Afteradjustedbyinflationandotherfactors,theactualannualgrowthratewas13%.Therefore,inrecentyears,Forthepastdecades,controllingthegrowthofhealthservicehasbecomeoneofthegoalsofChina'smedicalandhealthsystemreform.AsChinaentersanagingsociety,thenumberofelderlypeoplehasrisensharply.Accordingtothelateststatistics,atoftheendof2017,thenumberofpeopleaged60andoverinChinawas2.4billion(theresultsofthesixthcensusin2010were1.78billion),accountingfor17.3%ofthetotalpopulation(theresultofthesixthcensuswas13.26%);thenumberofpeopleagedover65was158million(theresultofthesixthcensuswas119million),accountingforMorethan11.5%(theresultsofthesixthcensuswas8.87%).Duetotherecessionofphysiologicalfunctions,theelderlyhaveimmunesuppression,ahighprevalencerate,alongperiodofillness,ahighercostoftreatment,andagreaterdemandformedicalservicesthanyoungpeople.Theincreaseinthenumberoftheelderlyaccountforthecontinuousriseintheirmedicalexpenses,aswellastheincreaseintheproportionofmedicalexpensestototalconsumption.Realisticallyspeaking,therapidgrowthofmedicalconsumptionfortheelderlyhasbecomeanindisputablefact.AccordingtothedataofChinaMedicalandHealthDevelopmentReport,basedonthecurrentgrowthrateofpercapitamedicalexpenses,suchincreaseinthemedicalexpenditureoftheelderlypopulationpartlyexplainfortheannualincreaseinGDPpercapita.In2015,medicalexpensesfortheelderlypopulationconsistedof4.9%inGDP.Inthelongrun,theratioisestimatedtobecloseto20%in2035.Tobemorespecifically,thereisalsoanobviousdifferencebetweenthemedicalspendingoftheagedincitiesandcounties.Theinefficientlysatisfieddemandofmedicalserviceoftheagingpeopleincountrysideregionsleadstosuchdifferences.Sincetheinadequatesupplyofmedicalserviceandinsurancesystem,thereremainsseverehealthproblemsofruralagingpeople.AccordingtoNationalhealthsurveydata,theprevalenceofpeopleagedover65inruralareasis47.5%,whichis6timesofthatincities.Therefore,thephysicalconditionsoftheelderlyandtheconcomitanthealthyproblemsinevitablybecomeanimportantpartofChina'ssocialdevelopment.Athoroughstudyofmedicalserviceneedsoftheelderlyisrealisticallysignificant.Findingsfromthiskindofresearchcanserveasanimportantbasisforscientificresponsetothechallengesofaging.Basedontheabovethinking,thispaperwillusetheChineseprovincialpaneldatatoexplore,qualitativelyandquantitatively,thedeterminantsoftherapidincreaseofmedicalexpensesinChin.Iputemphasisontherelationshipsofagingandurban-ruraldifferencesonmedicalexpenditure.Ifindthatagingproblemissignificantlypositivetoindividualmedicalexpenditure.Besides,thereisurban-ruraldifferencesintherelationshipofagingandmedicalexpense.Specifically,increaseinagingofurbanareaswillpromotemedicalexpendituretoalargeextent,whiletheincreaseinagingofruralareasmayleadtoadecreaseintheexpense.Suchresultsindicatetheurgentdemandofgovernmenttoeliminatethedisparityofmedicalresourcesbetweencitiesandthecountryside.2.LiteratureReviewScholarsathomeandabroadhaveattachedgreatsignificancetothemedicalproblemsbroughtaboutbyaging.AccordingtoThivierge-RikardRV(2007)[1],themedicalexpensesandageoftheelderlyovertheageof60arepositivelyrelated,andthehealthconditionsthatvaryfrompersontopersonfurtherincreasemedicalexpenses.ChemichovskyandMarkowitz(2004)[2]usedIsrael'sempiricaldatatoshowthathouseholdincomeisanimportantfactoraffectingtherapidgrowthofmedicalexpenses,andthemedianagehasnotbeensignificantlyaffected.Agevariablespromotethegrowthofmedicalexpenses,reflectingthehigherneedformedicalexpensesfortheelderly,andthemaingroupsinthemedicalservicesupplyarealsofromwomen,Jews,high-incomepeopleandchronicallyillpatients.AccordingtoKaneRobert(2003)[3],theelderlypopulationtendstohavegenderdifferencesinmedicalexpenses,andmenarelowerthanfemales.Thereasonisthatthelifecycleoffemaleelderlypopulationislonger,whichisoftenhigherthanthatofordinarymales,whichmakesthefemaleelderlygroupstayinasinglestateforalongtime,thusincreasingthemedicalexpensesofthenursingcarelevel.Comparedwithdevelopedcountries,China'sagingpopulationinfluencesmedicalexpensesmainlyfromtwoaspects.Firstly,China'shealthcaresystemisundergoingrapidchangesandmayhavedifferentimpactsonpeoplebornindifferentperiods.Ontopofthat,alongwiththeincreaseinagingpopulation,thedifferenceinmedicalexpenditurebetweencitiesandcountrysidesrequireseparateanalysis.Manydomesticstudieshavethoroughlyanalyzedtheproblemofagingbasedonthesupplyofurbanandruralmedicalservices,medicalandhealthinvestment,andmedicalsecurity.Thedisparityinthesupplyofmedicalservicesbetweencitiesandcountieshasobjectivelyledtoagapintheaccessibilityofcorrespondingresidents.TheWHO(2005)[4]foundthatabout10%ofruralresidentshavetotravelatleast30minutestogetmedicalservices,whileurbanresidentsonlyhave1%.Liuetal.(2008)[5]foundthat15%ofurbanresidentsand22%ofruralresidentshavedifficultyaccessingmedicalcare,andthesituationinruralareasisstillworsening.Ontopofthat,thereexistsignificantgapinmedicalsecuritysystembetweenthecitiesandcountrysideYip(2009)[6]foundthatgovernmentinvestmentinurbanareasis5-6timesthatofruralareas.Atthesametime,governmenthealthinvestmentisurban-oriented,especiallybefore2003,whichwasmainlyinvestedinurbanmedicalinsuranceandhardwareconstructionoflargemedicalinstitutions.Inaddition,therearealsosignificantdifferencesintheurbanandruralmedicalsecuritysystems.Urbanresidentsarecoveredbyrelativelycompletemedicalsecuritysystem.ThoughtheNewRuralCooperativeMedicalSystemhascontinuedtoexpanditscoveragesince2003,itisstillmuchlowerthanthatofcities.Thereisnoticeablegapbetweenmedicalexpendituresinthetworegions.Forexample,MengXinandKristinYang(2006)[7]foundthat,onaverage,urbanresidentsintheir60sspend50%-100%moreinmedicalexpensethanresidentsaged40,andpeopleaged80spend100%-170%moreformedicalexpensesthanpeopleintheir40s.3.CurrentsituationsofmedicalexpenditureinChina3.1TheincreaseintotalhealthexpenditureThetotalhealthexpenditureisthetotalamountofmoneyusedbythewholesocietytopayforhealthservicesinacertainperiodoftime,mostofwhichismedicalexpenses.China'stotalhealthexpenditurehasincreasedyearbyyear.In1999,totalhealthexpendituremakeupfor4%ofGDP,andindividualmedicalexpenseswas65yuan.In2000,thesetwoindicatorswere4.6%and362yuanrespectively.In2010,itwas5%and1400yuanrespectively.Thetotalhealthexpenditureconsistsofthreeparts:governmentexpenditure,socialexpenditureandpersonalexpenditure.Figure1showsthatthelevelsofthethreebranchesareincreasing,andthereisasignificantaccelerationafter2007.Figure1:TheincreaseofthreebranchesoftotalmedicalexpenditureDatasource:China'sstatisticsbureau3.2UrbanandruraldisparityofindividualmedicalexpendituresFromtheperspectiveofurban-ruraldifferences,thelargegapinthelevelofmedicalexpenditureisaprominentproblemintheallocationofmedicalresourcesinChina.In1890,individualhealthexpenditureincitywas1.35timesofthatincountryside.Whenitreacheditshighestpointin2000,itwas3.63times.Thoughtheproportiondecreasedthen,thedisparityremainsasevereproblem.Althoughthe“NRCMS”participationratehasgrownrapidlysince2003,itsreimbursementrateisrelativelylow,about41%,whiletheaveragereimbursementrateforurbanworkers'medicalinsuranceis65%.Fromfigure2,whencomparedwithurbanresidents,itistellingthatthemedicalneedsofruralresidentsaresomewhatinhibited.Figure2:ThreebranchesofmedicalexpensesDatasource:China'sstatisticsbureau3.3Self-assessmentofphysicalconditionsoftheseniorinChinaIntheprocessofthesixthnationalcensussurvey,theself-assessmentofhealthstatuswasadoptedfortheelderly.Theoptionsincluded“health”,“basichealth”,“unhealthybutself-care”and“noself-careability”.Fromthesurveyresults(seeTable1),theproportionoftheelderlyinthecountryis43.82%,theproportionofbasichealthis39.33%,andtheremaining16.85%areunhealthyorunabletotakecareofthemselves.In2010,thereareover17.765millionofpeoplewhoagedover60inChina.Thatmeansthephysicalconditionsofatleast30millionofelderlypeopleinthecountryareunhealthy.Comparingtownandvillages,thescaleofurbanresidents'self-evaluationof“health”ishigherthanthatofruralelderly,andtheratiosofunhealthyornoself-careabilityarelowerthanthatofruralelderly.Wecantellthattheseniorpeoplewholiveinthecitiesgenerallyexperiencebetterphysicalconditions.Inotherwords,ruralelderlyhavemoremedicalserviceneedsthanurbanelderly.Table1Self-assessmentofhealthstatusofpeopleagedmorethan65in2010HealthBasichealthUnhealthybutself-careNoself-careabilityNationwide43.82%39.33%13.9%2.95%Urbanareas48.35%40.34%9.86%1.45%Ruralareas40.42%38.92%16.94%3.72%Datasource:Thesixthcensus3.4PrevalenceoftwoweeksandchronicdiseasesofelderlypeopleThetwo-weekprevalencerateandtheprevalenceofchronicdiseasesareimportantfactorstomeasuretheneedsofmedicalserviceoftheelderlypeople.Table2showsthat,from1993to2013,thetwoprevalenceofseniorgroupsareclearlylargerthanothers.Thetwo-weekprevalencerateofresidentsovertheageof60hasrisensharplyfrom25%in1993to62.2%in2013,amorethandoubledincrease.Comparedwithotheragegroups,theweeklyincreaseintheprevalencerateisthelargestamongthepopulationover65yearsold.Accordingtothedatain2013,thetwo-weeksprevalenceandchronicdiseaseprevalenceoftheelderlyover65yearsoldwere2.58timesand2.2timeshigherthanthatoftheaverage,whichreferstothefactthattheelderlypopulationhasahigherprevalence,requiringmorehealthservice.Table2:Theprevalenceoftwoweeksandchronicdiseases(unit:%)Datasource:Chinesecalendaryearhealthstatisticsyearbook4.Dataandvariables4.1Data"ChinaStatisticalYearbook","ChinaHealthStatisticsYearbook"and"ChinaLaborStatisticsYearbook"arethemaindatasources.Iadoptprovincialpaneldataof30provinces,municipalitiesandautonomousregionsinthemainland,excepttheTibetAutonomousRegion.Thesamplesizeis180,coveringfrom2012to2017.Mostvariableshavesizableregionalvariations.4.2DescriptivestatisticsThedatainTable3showsthattheagingpopulationhasbeenmaintainedabove0.09from2012to2017,andthereisagradualincreasetrend,whichreflectsChina'sagingproblem.Themeanmortalityratewasquitstableduringtheseyears.PercapitaGDP,whichisindicatedbyI,hasincreasedfrom40093.4yuanto57485.6yuan,revealingthattheendogenouspowerofChina'seconomicdevelopmentstillexists.Withthegovernmentandsocietyattachinggreatimportancetoandinjectingcapitalsintopharmaceuticalsindustry，thereisanannualincreaseintheproportionofhealthtechniciansperthousandpeople.Besides,thereisalsoanobviousincreaseinthemedicalexpenditure,whichisshownasY,inmorerecentyears.Table3:Descriptivestatisticsofexplanatoryvariablesin30provinces201220132014201520162017Aging0.090.090.030.020.020.020.020.170.02Deathrate0.0620.0670.0560.0610.760.0450.740.770.730.710.790.82GDP40093.444075.848106.551468.353796.557485.618448.019368.420603.321712.522971.925407.4Technicians3.9814.1904.6435.3175.7156.2970.8201.1701.3141.1341.1151.199Urbanization0.5450.5550.5650.5760.5880.6150.1300.1270.1230.1170.1130.105Elderlysupport12.2312.4112.5712.7612.8211.412.132.392.302.232.302.05Expenditure843.122950.5161048.6321116.1091300.3771935.052225.237231.956253.758288.209377.074504.0225.Modelandmethodology5.1.ModelspecificationBasedontheprovincialpaneldatafrom2012to2017,thispaperempiricallyexaminestheinfluencingfactorsofagingonbasicmedicalexpensesthroughthepanelmodel,andthenexploresitsinternalimpactmechanism.Theeconometricmodeltobeusedinthispaperisshownbelow.Yit=β0+β1Ait-1+β2Dit+β3Iit+β4Xit+εit(1)Inequation(1),thevariableYitistheindividualmedicalcostofthemeasuredjurisdiction.Amongtheindependentvariables,Ait-1istheproportionofthepopulationover65yearsold,whichisusedasanindicatorofthedegreeofagingofthepopulation.Inordertoeliminatetheendogeneityproblem,thelagphaseofagingdatawillbeusedastheindicator.Ditmeasuresthemortalityrate.ThecontrolvariableIitreferstothepercapitaGDP,andXitcoverstheproportionofurbanpopulation,andthenumberofhealthtechniciansper1,000population.Amongthem,theexistingresearchshowsthateconomicgrowthperformanceisanimportantfactoraffectingbasicmedicalexpenses,butmedicalexpensesmayvaryduetotheurban-ruralstructure.ItisdifficulttoobtaincomprehensivelybasedonruralmedicaldatainChina,sothecontrolvariablesincludeGDPpercapita,theproportionofurbanpopulation.Inaddition,theaccessibilityofmedicalresourcesdirectlyaffectsthebasicmedicalexpenses,thusthenumberofhealthtechniciansper1,000populationisappliedtomeasurethesupplyofmedicalservices.Sinceinrecentyears,thehealthinsurancehascoveredawildrangeofpeople,itdosenotshowmuchdifferencewithinprovinces,thustheinsurancecoveragerateisexcluded.Inthemodel,itiscomplicatedtocapturetheinfluenceofmedicaltechnologyprogressonmedicalexpenditure.Thechangeofmedicaltechnologyisdifficulttomeasure.Consideringthatsuchchangesmayvarywithtime,abettersolutionistousethetimedummyvariabletocapturetheinfluenceofmedicaltechnology.Besides,inordertoeliminatediffidenceamongprovinces,Iimplementprovincedummyvariablesintothemodel.6.Empiricalresults6.1BenchmarkresultsBasedontheempiricalmodelconstructedaboveandthedescriptivestatisticsofeachvariable,Table4showsthebenchmarkregressionresults.Ifirstexploretheconnectionbetweenthenumberofagingpeopleandmedicalexpense.TheregressionresultsareshowninTable4.InTable4,column(1)onlycontrolsthedegreeofaging,theeffectsofprovincesandtimevariablesonmedicalexpenditures.Inthesecondcolumn,variablessuchasthenumberofmedicaltechniciansper1,000peopleandtheurbanizationrateareadded,buttheprovincedummywerenotcontrolled,anditcanbeseenthattheeffectofagingonmedicalspendingbecomelesssignificant.Inthethirdcolumn,allvariablesareaddedforfixed-effectsmodelanalysis,andinthefourthcolumn,randomeffectsareimplemented.Itcanbeseenfromthisthatadvancesinmedicaltechnologyindifferentyearsandactualdifferencesindifferentprovinceswillhaveacertainimpactonmedicalexpenditures.Fromtheresultsinthefirstandsecondcolumns,wecantellthatwhenGDP,mortalityandotherrelatedvariablesareincreased,theimpactofagingonmedicalexpenditureshasdecreasedfrom2.123to1.273,whichindicatesthatfactorssuchasincomeandphysicalcapitalhaveeffectonmedicalexpenditures.WhenpercapitaGDPanddeathratesrise,people'sexpenditureonhealthcarewillincrease.Withtheincreaseofhumanandmaterialcapital,whichmeansthelevelofmedicalserviceinthesocietyimproves,thepublicmedicalexpenditurewilldeclinetoacertainextent.Underthecircumstancesthattheprovinceandtimevariablesarecontrolled,theelasticityofagingtopercapitamedicalexpenditureis1.872(atasignificantlevelof5%),thatis,forevery1%increaseinaging,medicalexpenditurewillincreaseby1.872%.Theempiricaltestoftheaboveofindividualmedicalexpensesshowsthateconomicdevelopmentcontributestotheincreaseinbasicmedicalexpenses,aswellastheriseinthesupplyofmedicalservices(suchasincreasingthenumberofhealthtechnicians)helpstocurbtherapidgrowthofbasicmedicalexpenses.Thisisexactlythesameasreality:thelevelofpeople’slivingstandardhasincreased,thecorrespondinginfrastructurehasincreased,andthequalityofpublicservicefacilitieshasimproved.Thishasgreatlypromotedtheruralimmigrantstomovetourbanareas.Theaccessibilityofmedicalresourcesfortheseresidentshasbeenimproved.Therebyreducingthemedicalexpensesduetodelayedtreatment,andultimatelycontributingtothereductionofpercapitamedicalexpenses.Table4:Benchmarkregressionresults(1)(2)(3)(4)FEFEFEREExpenditureExpenditureExpenditureExpenditureAging（A)2.123**1.273*1.872**1.771(1.99)(1.78)(2.42)(0.87)GDP(I)0.109***0.011***0.021(5.02)(6.32)(1.25)Death(D)0.8920.887*0.918**(0.32)(1.79)(2.19)Technician（X1）-0.627-1.061**-0.434(-0.94)(2.66)(-1.24)Urbanization（X2）-0.081-0.222.011***(-0.62)(-1.07)(3.54)YearYesYesYesNoProvYesNoYesNoCons10.213***0.259***-1.243***0.723(9.21)(3.47)(-3.23)(0.12)N180180180180AdjR20.8340.8480.8930.624Notes:tstatisticsinparentheses.*p<0.1,**p<0.05,***p<0.01Basedontheabovediscussion,IconductedHausmantest.Fromtheresults,theHausmantestacceptedthesettingofthefixed-effectpanelmodel,whichisconsistentwiththepreviousempiricalresults.Accordingtothetestresults,thefixedeffectsmodelanalysiswillbemainlyimplementedinfurtherregressionanalysis.Table5：HausmanTestFEREaging（A)1.427**1.232(2.40)(0.76)GDP(I)0.022***0.012***(4.31)(4.29)Death(D)0.802**0.879**(2.31)(2.06)Urbanizationrate（X1）-0.087*-0.214***(-1.96)(-3.09)X20.465**1.827***(2.66)(3.27)_cons-6.1320.982(-1.42)(0.18)N180180AdjR20.7320.629Hausman15.44***Notes:tstatisticsinparentheses.*p<0.1,**p<0.05,***p<0.016.2RobustnesstestTheaboveanalysisexplorestheinfluencingfactorsonindividualhealthexpensethroughregressionanalysisofagingpopulation,mortalityandcontrolvariables.Inthefollowing,therobustnesstestofthepanelmodelresultswillbefurtherperformed.ConsideringthattheimplementeddataisshortpaneldatawithalargenandasmallT,thefollowingwillusetheGeneralizedMethodofMomentstoconductrobustnesstestwiththelagoftheexplanatoryvariableastheexplanatoryvariable.AccordingtotheresultsoftheGMMmodel,thelaggingperiodofpercapitamedicalexpenditurehasasignificantpositiveimpactonmedicalexpenditure,indicatingthatpeople'sexpenditureonhealthcareisarelativelylong-termprocess.Inaddition,populationagingandmortalityhaveapositiveeffectonmedicalspending,butpercapitaGDPhasnotshownstatisticalsignificance.Theresultsintable6furtherverifythattheaboveestimatesarerelativelyrobust.Table6：GMMtestYL.Y0.722***(3.32)Aging1.915**(2.21)GDP0.006(1.22)Deathrate0.201**(2.67)Urbanizationrate0.311(1.87)Meditechnician0.763(1.56)_cons-3.918(-0.87)N1506.3Rural-urbandifferencesonmedicalexpenditureBelowIfurtheranalyzehowdoseagingincitiesandcountrysidesaffectmedicalexpenditure.(table7).Theempiricalmodelequationsettingsareconsistentwithcolumns(3)and(4)inTable5,butaresubdividedintourbanandruralagingontheagingindex.Fromtheregressionresults(seecolumn(3)ofTable4),InadditiontofactorssuchasactualpercapitaGDPandmortality,whichsignificantlyaffectindividualmedicalexpendituresinthesamedirection,urbanandruralaginghasanoppositeeffectonactualmedicalexpenditures.Fromtable7,agingproblemhasapositiveeffectonmedicalexpense,and1%increaseinagingofurbancitizenswillresultin3.082%(in5%Significantlevel)increaseintheexpenditure.However,1%increaseinruralagingcanleadto1.604%decreaseinmedicalexpense.Suchresultsmayindicatethat,tosomeextent,theneedofmedicalserviceofpeoplelivinginruralareasisnotefficientlysatisfied,orevenhavenoaccesstomedicalresource.Besides,elderlysupportratiosinbothurbanandruralareasarealsoaddedintheregression.Inruralareas,elderlysupportratioisnotsignificantlyrelatedtomedicalexpenditures.Thisresultindicatesthatsincetheincomelevelinruralareasisquitelow,peoplehavetomeetthebasiclivingneeds，thusdonothaveextramoneyformedicalservice.Atthesametime,atleastitcanbeexplainedthatifthemedicalexpensesoftheagingpopulationintheurbanareasareusedasthebenchmark,onlymeetingthemedicalneedsoftheelderlypopulationinthefuturewillleadtorapidgrowthinmedicalexpenditure.Further,thenumberofmedicaltechniciansinurbanareasalsodonotexertsignificantinfluenceontheexpense,sincerelativelydevelopedcitieshaveadequatesupplyofmedicalresource.Inotherwords,ifweconsidertheintegrationofurbanandruralareasandloweringofthedifferenceofmedicalservicesbetweencitiesandcountrysidesinthefuture,theagingofruralareaswillpromoterapidgrowthinmedicalexpenditures.Table7Rural-urbandifferencesonmedicalexpenditureYuYrAging3.082***-1.604**(8.903)(2.124)Elderlysupport0.3667**0.297(2.191)(0.982)Deathrate0.414**0.0711(1.996)(1.237)GDP0.021***0.093**(6.223)(1.972)Technicians-0.169-0.213**(0.328)(2.143）YearYesYesProvYesYescons1.14**2.658(2.40)（1.356）N180180AdjR20.9470.9447.PolicyrecommendationsAstheagingprocesscontinuestoaccelerate,medicalexpenseswillcontinuetoshowahightrendintheshortterm.Theincreaseinthedegreeofagingincitiescansignificantlyincreasemedicalexpenditures,whiletheincreaseinruralagingwillnotincreasemedicalexpenditures,andevenleadtoadeclineinself-financedmedicalexpenditures,indicatingthatthemedicalserviceneedsofruralelderlypopulationshavenotbeeneffectivelymet.Therefore,inthefuture,theyneedtosupply(suchasincreasingthenumberofmedicalinstitutions,Theproportionofmedicalstaff,etc.),demand(suchasimprovingthelevelofruralresidents'medicalinsurancereimbursement,etc.)toincreaseinvestmentinruralmedicalservices..InordertoeffectivelycontroltherapidriseofChina'sbasicmedicalexpenses,therearesomemeasuresthataresupposedtobetaken:First,vigorouslyadvocatethesocialoperationoftheelderlymedicalandhealthservices,allowingcertainsocialcapitaltoentertheelderlymedicalmarketwillincreasethesupplyfortheelderly,andsatisfythedemandsofmedicalservicestoagreaterextent.Thesecondistoestablishsoundmedicalsystem.Specifically,itisencouragedtoincreasefinancialaidoftrainhealthtechnicians.Weakeningtheregionaldifferencesandeliminatingregionalinclinationofmedicalandhealthresourcesalsohelptoeasetheproblem.Formulatingappropriateandreasonablefiscalandtaxationsystemsandpreferentialpolicies,vigorouslyencourage"neartreatment"alsoreducetheexcessivewasteofmedicalresourcesintertiaryhospitals.OnlyundertheconditionsthatweeffectivelycontroltheriseofChina'sbasicmedicalexpenses,avoidexcessiveinternalconsumptionofhealthresources,andultimatelyachieveabenignsocialpensionandhealthcarematchingdevelopmentmodel.8.Conclusionandlimitation:Inthispaper,firstly,IintroducedtheincreaseofmedicalexpenditureduringthepastdecadesinChina,andsomegraphisappliedtodemonstratetherelationshipsbetweenagingandhealthexpense,intuitively.Totestthequantitativerelationshipswithinthetwofactors,Imainlyusetheprovincialmacropaneldatatoconductempiricalcorrelationmeasurementonindividualmedicalexpenses.Basedontheempirical