【摘要】 基于2013—2023年我国除香港、台湾、澳门外的31个省（自治区、直辖市）的面板数据，构建居民人均医疗保健支出增长率、医疗负担系数、政府支出效能、收入弹性和区域差异指数五个衍生变量，结合原始指标，采用K-means聚类算法将全国划分为三类区域。在此基础上，分别构建双向固定效应模型，分区域实证检验医疗保健支出的影响因素。研究结果表明，我国医疗保健支出呈现明显的区域异质性和多因素驱动特征；第一类地区的人均可支配收入对居民人均医疗保健支出具有显著促进作用，其他影响因素不显著；第二类地区的居民人均医疗保健支出同时受到人均可支配收入与每万人拥有卫生技术人员数的显著正向影响；第三类地区的居民人均医疗保健支出则显著受到老年人口比例、卫生机构数、每万人拥有卫生技术人员数以及R&D经费内部支出的影响。基于此，建议各地基于区域差异制定针对性政策，优化资源配置，提升医疗服务的公平与效率。更多还原

【Abstract】 Based on panel data from 31 provinces(autonomous regions and municipalities directly under the central government) in China,excluding Hong Kong,Taiwan,and Macao,from 2013 to 2023,this study constructs five derived variables such as growth rate of residents′ per capita healthcare expenditure,healthcare burden coefficient,government expenditure efficiency,income elasticity,and regional disparity index,and combines them with original indicators. divides the 31 provinces(autonomous regions and municipalities directly under the central government) into three regional categories by using the K-means clustering algorithm.On this basis,bidirectional fixed-effects models were constructed for each region to empirically examine the determinants of healthcare expenditure.The research findings indicate that China′s healthcare spending exhibits pronounced regional heterogeneity and multifactorial drivers;in the first region,per capita disposable income significantly promotes residents′ per capita healthcare expenditure,while other influencing factors are insignificant;in the second region,both per capita disposable income and the number of health technicians per 10 000 population have significant positive effects on residents′ per capita healthcare expenditure;in the third region,the proportion of elderly population,the number of health institutions, the number of health technicians per 10 000 population,and internal expenditure on R&D all demonstrate significant influences residents′ per capita healthcare expenditure.Based on these findings,it is recommended that regions formulate targeted policies based on regional differences to optimize resource allocation and enhance the equity and efficiency of healthcare services.更多还原