Spatiotemporal Evolution and Drivers of Total Health Expenditure across Mainland China in Recent Years

A substantially growing health expenditure has become an important global issue. Thus, how and why health expenditure is rising should be urgently investigated in systematic research. The Bayesian space-time model and the Bayesian least absolute shrinkage and selection operator (LASSO) model were employed in this study to investigate the spatiotemporal trends and influence patterns of total health expenditure per capita (THEPC) and total health expenditure (THEE) as a share of the gross domestic product (GDP) on the Chinese mainland from 2009 to 2018. The spatial distribution of THEE as a share of GDP in mainland China has shaped a distinct geographical structure with the characteristic of ‘west high/east low’. Its local increasing trends formed a geographical structure that exhibited a ‘north high/south low’ feature. The heterogeneity of the influence patterns of health expenditure was observed from east to west across China. Natural environmental factors, such as air pollution and green coverage, along with changes in dietary structures, have increasingly influenced the growth of health expenditures.