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Who is Paying for Healthcare and School Enrollment? —A Study Based on County-Level Panel Data in China from 2000 to 2023

In: Proceedings of the 2026 2nd International Conference on Data Mining and Project Management (DMPM 2026)

Author

Listed:
  • Zhe Li

    (City University of Macau, Faculty of Finance)

  • Di Hu

    (City University of Macau, Faculty of Finance)

  • Wushen Huang

    (City University of Macau, Faculty of Finance)

  • Ziyun Wang

    (Hainan Vocational University of Science and Technology, School of Accounting)

Abstract

This paper proposes a simple unit fiscal burden (UFB) framework to track sector-specific cost dynamics in local public services. Using county-level panel data in China from 2000–2023, we construct UFB measures for healthcare and primary education as sectoral public expenditure per unit of service capacity (hospital beds and primary-school enrollment), expressed in logs. We document a persistent divergence in which expenditure grows much faster than capacity, implying sustained increases in unit burdens. Fixed-effects regressions show that both fiscal capacity (per-capita budget revenue) and fiscal pressure (the expenditure-to-revenue ratio) are positively and significantly associated with UFB in both sectors. Moreover, the association between fiscal capacity and UFB is stronger in high-pressure counties, consistent with tighter budget constraints amplifying cost intensity rather than facilitating proportional capacity expansion. The proposed indicators provide a practical tool for monitoring fiscal risk and service-cost inflation at the local level.

Suggested Citation

  • Zhe Li & Di Hu & Wushen Huang & Ziyun Wang, 2026. "Who is Paying for Healthcare and School Enrollment? —A Study Based on County-Level Panel Data in China from 2000 to 2023," Advances in Economics, Business and Management Research, in: Ljiljana Trajkovic & José Alfredo F. Costa & Zaher Al Aghbari & Nor Azman Ismail & Dariusz Jacek Jak (ed.), Proceedings of the 2026 2nd International Conference on Data Mining and Project Management (DMPM 2026), pages 70-82, Springer.
    • Handle: RePEc:spr:advbcp:978-94-6239-689-0_8
    DOI: 10.2991/978-94-6239-689-0_8
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