# Community health care integration and fiscal expenditures: evidence from a synthetic control approach

**Authors:** Yi Xiang, Guangjing Zhong, Xiaofeng Lei, Longqing Liu

PMC · DOI: 10.3389/fpubh.2025.1524984 · Frontiers in Public Health · 2025-05-23

## TL;DR

This study shows that integrating community healthcare in Yantai, China, reduced government spending on healthcare, helping to ease fiscal burdens.

## Contribution

The study provides novel evidence on the fiscal impact of community healthcare integration using a synthetic control approach.

## Key findings

- Community healthcare integration in Yantai significantly reduced fiscal expenditures.
- The expenditure decrease was solely due to the policy, with no confounding variables.
- Government healthcare spending in pilot zones was the main factor in reduced costs.

## Abstract

Does the implementation of community healthcare integration policies affect fiscal expenditures as a key measure in addressing older healthcare demands and promoting healthy aging?

This study utilizes the implementation of community healthcare integration in Yantai, a prefecture-level city in China, as a natural experiment to analyze its fiscal expenditure consequences by using the synthetic control approach.

Our empirical findings indicate that the program implementation markedly decreased fiscal expenditures in pilot cities. The decrease in expenditure is solely due to policy execution, with no confounding variables detected. The program implementation negatively impacted fiscal expenditures mainly by decreasing government healthcare spending in pilot zones.

Consequently, in the ongoing effort to enhance community healthcare integration, local governments must devise context-tailored implementation strategies to attain sustainable growth, alleviate fiscal burdens, and improve older adult care services.

## Full-text entities

- **Diseases:** diabetes (MESH:D003920), chronic disease (MESH:D002908), hypertension (MESH:D006973)
- **Species:** Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12143234/full.md

## References

40 references — full list in the complete paper: https://tomesphere.com/paper/PMC12143234/full.md

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Source: https://tomesphere.com/paper/PMC12143234