Evaluating Developmental Stages of Total Health Expenditures in China

Abstract Objective This study evaluated developmental stages and trends of Total Healthcare Expenditure (THE) of 18 provinces in China. We explored characteristics of different development stages during healthcare expenditure, to provide scientific reference for China's healthcare policy making and regional healthcare planning.Methods Firstly, curve fitting and parameter estimation using SPSS21 software were carried out for the Logistic function model, and then the three-point or four-point method was applied to estimate the value of saturation K. Finally the Logistic function equation and fitting graph were obtained. According to the nature of Logistic curve, the study divided THE into three stages, gradual, rapid and slow growth, and predicted and analyzed THE developments in 18 provinces.Results By 2019, 15 provinces have entered a period of rapid THE growth. Regionally, the time to enter fast growth period early to late are in the order of northeast ( in 2005), east China ( in 2008), northwest ( in 2010), south China ( in 2013), north China ( in 2015) and southwest ( in 2015). The earliest province to enter rapid growth period is Liaoning province (in 2005), Shandong province enter the period at latest (in 2045). In 2027, all 18 provinces will enter the rapid growth period, and end in 2045. In this period, rapid growth in total health expense will last for about 23 years, with an average annual growth rate of 8.69%. Conclusions THE growth pattern is in line with typical trend of "slow-fast-slow" growth function. The expense developments vary between regions. Eastern region entered rapid and slow growth period later than the central and western regions. THE development stages and duration of the rapid growth period is correlated to regional economic level. The earlier it enters the fast growth period, the shorter it lasts, and vice versa. The government should take advantage of this period, from 2015 to 2029, to make policy preparations to respond THE rapid growth in China.