分类号F061.5密级
U D C 332编号10486
武汉大学
硕士学位论文
高铁开通与发展对城市医疗卫生服
务享有水平的影响研究
研究生姓名：马雨希
学号：2018206320002
指导教师姓名、职称：杨刚强副教授
学科、专业名称：区域经济学
研究方向：区域公共服务
二零二一年六月
Research on the impact of high-speed
railway connection and development on the
level of medical and health public services
of cities
By Ma Yuxi
June ,2021
高铁开通与发展对城市医疗卫生服务享有水平的影响研究
摘要
高铁开通对中国经济发展产生了日益显著的影响，高铁开通的社会经济效应
已经得到了较为充分的研究。对于区域发展而言，经济发展是根本，而解决新时
代我国社会主要矛盾即满足人民日益增长的美好生活需要同样离不开社会事业
的进步，其中，医疗卫生服务以其关乎亿万人民福祉、维护社会公平正义、提高
人民生活质量的重要作用成为社会事业发展的重中之重。本文通过引入城市发展
要素，探究新时代以高铁为代表的区域高速交通基础设施改善对公共服务享有水
平的影响阶段特征和个体特征，并试图探究高速铁路时代城市医疗卫生服务供给
的优化路径。
在阐述相关理论和文献梳理的基础上，本文认为高速铁路开通与发展对于城
市医疗卫生服务的影响实现路径为：高速铁路开通产生时空压缩效应，提升区域
可达性；随后降低客运成本，提高通勤效率，加快生产要素流动；促进区域间人
口和贸易交流，打破区域发展壁垒，加强城市联系并进一步扩大现代服务业的市
场范围，促进区域经济社会一体化；进而提高公共服务外溢性，对特定区域内医
疗卫生公共服务的供给产生一定的冲击。
进一步的，本文运用宏观数据进行实证检验。运用2007年至2018年全国
67城市面板数据，构建双向固定效应的实证模型，研究高铁开通对各城市医疗
卫生服务享有水平的直接效应和动态效应。得到以下结论：第一，高铁开通显著
降低了医疗卫生公共服务的人均水平，并且有立竿见影的效果，但随着高铁开通
年限的增加，负向效应将转向正向作用并在高铁开通数年之后对城市医疗卫生服
务人均水平产生显著的正向影响。第二，异质性研究表明，不同人口规模的城市、
不同经济区域、不同行政等级、不同财政能力的城市高铁开通效应差异明显，本
文分析认为与城市人口密度、财政行为、医疗卫生投资水平有关。可见，高铁开
通对医疗卫生服务享有水平的影响是基于经济、人口、政府等多个角度作用的结
果。第三，优化机制检验结果表明，地方政府在财政分权体制下提升人均医疗卫
生财政支出，在加大医疗卫生领域的财政投资的同时引导社会资本对该领域的关
注、加大医疗卫生事业投入力度、发挥铁路在人口布局方面的作用等途径，均能
带来城市医疗卫生公共服务水平的总体提高。本文的政策意义在于，准确评价高
铁开通对医疗卫生公共服务享有水平的影响，对即将到来的高铁建设“八纵八横”
时代如何改善公共服务供给方式、完善公共服务体系来实现更加均等化与共享发
展、实现城市在新时代的高质量发展有着重要意义。
关键词：高铁，医疗卫生服务，优化机制
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武汉大学硕士学位论文
Abstract
The construction of high-speed railway (HSR)has had an increasingly significant
impact on China's economic development,and the social and economic effects of
HSR have been fully studied.For regional development,economic development is the
core factor,but the progress of the social welfare can not be ignored.The medical and
health service has become the top priority in the development of social undertakings
because of it’s important role in the welfare of hundreds of millions of people and the
maintenance of social equity and justice.Considering the different factors of cities,
this research explores the impact of the improvement of regional transport
infrastructure represented by HSR on the level of public services in the new era,and
attempts to explore the effective means to improve the supply of medical and health
services.
On the basis of relevant theories and literature review,this paper believes that the
impact of the connection and development of HSR on urban medical and health
services happens through the following paths.The HSR connection produces the
space-time compression effect,improves the regional accessibility,then reduces the
cost of passenger transport,improves the commuting efficiency,speeds up the flow of
production factors,promotes the inter regional population and trade exchanges,breaks
the regional development barriers,strengthens the regional connection,further
expands the market scope of the modern service industry,promotes the regional
economic and social integration,promotes the spillover of public services,and has a
certain impact on the allocation of medical and health services in a specific region.
Further,this paper uses macro data for empirical test.Based on the panel data of 67
cities in China from 2007to 2018,this research constructs a two-way fixed
difference-in-difference empirical model to study the direct and dynamic effects of
the HSR connection on the level of public health services.The conclusions are as
follows:First,the HSR connection significantly reduces the per capita level of
medical and health public services,and has an immediate effect.However,with the
development of HSR,the negative effect will turn to positive effect,and a significant
positive effect on the per capita level of medical and health services shows after
several years since HSR connection.Second,heterogeneity research shows that the
effect of HSR connection in cities with different population size,different political
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高铁开通与发展对城市医疗卫生服务享有水平的影响研究
attributes and different financial capacity,and sited in different economic regions is
significantly different.This paper analyzes that the different effect in different cities is
related to the population density,financial expenditure and the investment level of
medical and health field.It can be seen that the impact of the HSR connection on the
level of medical and health services is based on the effect of economic development,
population,government and other aspects.Third,the test results of optimization
mechanism show that under the fiscal decentralization system,the local government
can play its autonomy in improving the preference of medical and health financial
expenditure,increasing the financial investment in the field of medical and health,
reasonably guiding the attention of social capital in this field,increasing the
investment in medical and health services,promoting the improvement of medical and
health services level.The significance of this paper is to accurately evaluate the
impact of the HSR connection on the level of medical and health public services,
providing significant experience in improving the supply of public services and
update the supply system to achieve more equal and shared development in the "eight
vertical and eight horizontal"era of HSR construction,and realize the high-quality
development of the city in the new era.
Key words:High-speed Railway,Medical and Health Services,Optimization
Mechanism
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