Fiscal Decentralisation, Chinese Style: Good for Health Outcomes?

Hiroko Uchimura and Johannes Jütting ()
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Hiroko Uchimura: IDE-JETRO

No 264, OECD Development Centre Working Papers from OECD Publishing

Abstract: This paper analyses the effect of fiscal decentralisation on health outcomes in China using a panel data set with nationwide county-level data. We find that counties in more fiscally decentralised provinces have lower infant mortality rates than counties where the provincial government remains the main spending authority, if certain conditions are met. Spending responsibilities at the local level need to be matched with county governments’ own fiscal capacity. For county governments that have only limited revenues, the ability to spend on local public goods such as health care depends crucially upon intergovernmental transfers. The findings of this paper, therefore, support the common assertion that fiscal decentralisation can lead to more efficient production of local public goods, while also highlighting the conditions required for this result to be obtained. Ce papier analyse l’effet de la décentralisation fiscale sur la santé en Chine, à partir d’une analyse de panel avec des données de district recueilli au niveau national. Les auteurs trouvent que, sous certaines conditions, les districts aux systèmes plus décentralisés ont des taux de mortalité infantiles moins élevés que ceux où le gouvernement provincial reste la principale autorité. Les responsabilités pour les dépenses au niveau local doivent toutefois être accompagnées de capacités fiscales adéquates. Pour les gouvernements de districts à bas revenus, la capacité à investir dans des biens publics comme les services de santé, dépend principalement des transferts intergouvernementaux. Les analyses confirment l’argument selon lequel la décentralisation fiscale peut mener à une plus grande efficacité des biens publics, en soulignant les conditions nécessaires pour atteindre ce résultat.

Keywords: China; Chine; décentralisation fiscale; financement des services de santé; fiscal decentralisation; health; health-care finance; santé (search for similar items in EconPapers)
JEL-codes: H51 H72 H75 I18 (search for similar items in EconPapers)
Date: 2007-11-01
New Economics Papers: this item is included in nep-cna, nep-dev, nep-pbe, nep-tra and nep-ure
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Citations: View citations in EconPapers (2)

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Related works:
Journal Article: Fiscal Decentralization, Chinese Style: Good for Health Outcomes? (2009)
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Persistent link: https://EconPapers.repec.org/RePEc:oec:devaaa:264-en

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