동적패널모형을 이용한 도시화와 고령화에 관한 중국 지역경제 연구 = A Study on the Chinese Regional Economy Related to Urbanization and Ageing Using a Dynamic Panel Model

다국어 초록 (Multilingual Abstract)

Over the past four decades since the reform and opening-up, China has experienced rapid economic growth while simultaneously undergoing a transformation of its social structure. As a result of these changes, China’s economic scale has become the second largest in the world, and the spatial distribution of industrial, demographic, and social structures, as well as regional economies, has also changed. With the continued advancement of industrialization, urbanization, and population mobility, cities have gradually emerged as the main spaces in which economic activities and production factors are concentrated, thereby promoting improvements in production efficiency and the reorganization of regional development structures.
Along with sustained rapid economic growth, China’s development model has gradually entered a stage of structural transformation. This transformation has been observed simultaneously across multiple dimensions, including a slowdown in economic growth, the deepening of population ageing, the widening of regional imbalances, and the increasing burden on social security and public service systems. This shows that the Chinese economy can no longer rely solely on capital accumulation and the expansion of production factors and indicates the need for a transition from quantitative growth to qualitative development. Accordingly, it is necessary to analyze how adjustments in industrial, demographic, and social structures affect the quality of economic development, such as urbanization, price fluctuations, and health expenditure.
Since the reform and opening-up, China’s economy has achieved rapid growth through long-term reliance on the secondary industry, particularly manufacturing and heavy industry. However, development based on heavy industry or resource-intensive industries has intensified resource consumption and environmental pollution and has led to problems such as inter-industry imbalance and a weakening of employment absorption capacity. Since the 1990s, the tertiary industry, centered on the service sector and information industries, has grown rapidly, gradually diversifying the industrial structure and significantly improving economic efficiency and resilience. This transformation has gone beyond a simple adjustment of sectoral shares and has also exerted a substantial influence on the pace and spatial distribution of urbanization. In other words, the diversity and concentration of the industrial structure function as key factors shaping regional development patterns and the direction of population mobility.
Against this background, changes in the industrial structure have operated as an important economic mechanism shaping China’s urbanization process. The more developed eastern coastal regions have gradually formed diversified economic systems based on a high degree of openness, well-developed industrial linkages, and a high share of the service sector. In contrast, the central and western regions, characterized by a weaker industrial base and greater reliance on natural resources, tend to exhibit a relatively higher degree of industrial concentration. These structural differences have exerted a pronounced influence on the regionally differentiated patterns of urbanization in China. Greater industrial diversity can enhance economic resilience and employment absorption capacity, thereby promoting the completeness of urban functions and population agglomeration. Meanwhile, industrial concentration can attract population inflows and accelerate urban expansion through economies of scale and agglomeration effects. Therefore, industrial diversity or concentration should not be understood simply as a matter of superiority or inferiority, but rather as a structural choice determined by regional economic conditions and stages of development.
Meanwhile, similar to most other countries, China is experiencing significant changes in its demographic structure, marked by declining fertility rates and increasing life expectancy. In addition, the long-term implementation of planned birth policies—namely, the one-child policy —since the 1980s has led to a sharp decline in fertility rates, and since the beginning of the twenty-first century, the pace of population ageing has accelerated further. According to data from the National Bureau of Statistics of China, in 2023 the population aged 60 and above accounted for approximately one-fifth of the total population, with the elderly population reaching around 300 million. This indicates that China has entered a stage of severe population ageing.
Compared with developed countries, population ageing in China is characterized by the phenomenon of "ageing before becoming wealthy," while developed countries entered the stage of population ageing on the basis of high per capita income levels and well-established social security systems, and China began to experience a reversal in its demographic structure at a middle-income level. This indicates that the economic shocks caused by population ageing in China have become more complex, as the decline in the working-age population constrains potential growth, places sustained pressure on labor markets and capital accumulation, and simultaneously increases the burden on fiscal and social security systems.
The macroeconomic impacts of population ageing are not limited to a slowdown in economic growth, but also exert significant influences on price fluctuations. The resulting effects exhibit a dual nature and arise through opposing channels on the supply side and the demand side. On the supply side, the continuous decline in labor supply raises wages and production costs, and firms pass these increased production expenditures on to prices, thereby generating inflationary pressure. At the same time, population ageing can accelerate technological innovation and capital substitution, which to some extent mitigates price pressures caused by labor shortages. On the demand side, consumption by the elderly population tends to be concentrated in medical care, long-term care, and daily services, while the overall propensity to consume declines and the saving rate rises. As a result, aggregate demand weakens and may act as a factor restraining price increases.
In addition, differences in the pace of population ageing and economic structures between urban and rural areas may lead to spatial heterogeneity in the effects on price fluctuations. While the pace of population ageing is faster in urban areas, the higher share of the service sector contributes to a more diversified industrial structure and relatively diverse consumption patterns. In contrast, rural areas experience severe labor outflows and lower income levels, which limit consumption capacity. These differences may further intensify demand contraction and downward pressure on prices in rural regions.
Therefore, examining the relationship between population ageing and price fluctuations in China can help identify potential risks arising from changes in the demographic structure and provide insights for mitigating economic instability and promoting sustainable macroeconomic growth. In addition, analyzing differences between urban and rural areas in the effects on price fluctuations is of important significance for understanding the region-specific impacts of population ageing and for formulating differentiated macroeconomic policies and promoting balanced urban–rural development.
At the same time, China’s economic growth has been accompanied by a dual urban–rural structure. The household registration system implemented since the 1950s classified the population into urban and rural categories, and this institutional division has generated substantial disparities in income, education, social security, and public services. With respect to the medical insurance system, the urban population has generally enjoyed relatively more comprehensive medical coverage, whereas the rural population has long faced constraints such as limited coverage and lower subsidy levels. Despite a series of reforms to the medical insurance system implemented since the 2000s, significant urban–rural differences persist in the allocation of medical resources, the quality of services, and access to healthcare. In particular, rural migrants who work and reside in urban areas have not been able to obtain the same level of medical coverage as urban residents. This phenomenon of "semi-urbanization" reflects a structural imbalance between the process of urbanization and the social security system.
Compared with macroeconomic growth and price fluctuations, changes in health expenditure are regarded as indicators that more directly reflect progress in social structure and transformations in lifestyles. Health expenditure, as an expression of health capital accumulation and individual economic behavior, comprehensively reflects the influence of multiple factors, including stages of economic development, income distribution structures, and changes in demographic structure. Since the beginning of the twenty-first century, the demand for medical services in China has expanded rapidly. According to statistics from the National Health Commission of China, from 2000 to 2023, per capita health expenditure increased by approximately seventeen times, and the share of Healthl-related expenditure in total consumption expenditure has also continued to rise. These changes indicate that health expenditure is shifting from a basic subsistence cost toward an investment aimed at improving quality of life and healthy life expectancy.
Against this background, population ageing and urbanization operate as two key factors influencing health expenditure. Urbanization promotes the spatial concentration of medical resources and can enhance access to and utilization of medical services through the development of the health industry and improvements in service infrastructure. In addition, urbanization alters lifestyles, diversifies the structure of health-related consumption, and raises the level of health expenditure. Population ageing leads to higher prevalence of chronic diseases and increased demand for long-term care, thereby increasing health expenditure. Urbanization and population ageing affect health expenditure from both the supply side and the demand side, indicating that the continuous expansion of health expenditure cannot be fully explained by income growth alone, but rather arises from changes in social and demographic structures.
Research on health expenditure has been conducted from various perspectives, yet notable limitations remain. First, many existing studies have primarily examined factors such as income levels, environmental pollution, the allocation of health service resources, and prices, while failing to sufficiently consider social structural variables, namely urbanization, and demographic structural variables, namely population ageing. Second, studies on health expenditure based on regional data in China remain limited. In particular, China is a country in which rapid urbanization and deepening population ageing are occurring simultaneously. While some existing studies have examined the independent effects of either urbanization or population ageing on health expenditure, research that considers both factors simultaneously remains scarce.
In recent years, restrictions on population mobility in China have been gradually relaxed, allowing freer movement between urban and rural areas, which has strengthened the interconnections between urbanization and population ageing. Spatial redistribution of the population not only reshapes the distribution of urbanization but also intensifies regional imbalances in age structure, leading the two phenomena to advance simultaneously across both time and space. By simultaneously considering these two structural changes and analyzing their effects on health expenditure, it is possible to provide policy-relevant insights for improving social security systems, enhancing the effectiveness of health resource allocation, and promoting equity in healthcare.

목차 (Table of Contents)

• 제 1 장 서 론 1
• 제 1 절 연구목적 및 배경 1
• 제 2 절 연구의 구성, 방법 및 차별성 6
• 제 2 장 산업구조 다양성이 중국 도시화에 미치는 영향 9
• 제 1 절 서론 9
• 제 2 절 선행연구 13
• 제 3 절 분석모형 및 분석자료 16
• 제 4 절 산업구조 다양성이 도시화에 대한 실증분석 20
• 제 3 장 불균형 동적패널모형을 이용한 중국 고령화가 인플레이션에 미치는 영향 분석 36
• 제 1 절 서론 36
• 제 2 절 선행연구 39
• 제 3 절 분석모형 및 분석자료 42
• 제 4 절 고령화가 인플레이션에 대한 실증분석 47
• 제 4 장 지역 상관성 및 이질성과 공통요인을 고려한 중국 고령화와 도시화가 개인 의료지출에 미치는 영향 분석 65
• 제 1 절 서론 65
• 제 2 절 선행연구 69
• 제 3 절 분석모형 및 분석자료 73
• 제 4 절 고령화와 도시화가 개인 의료지출에 대한 실증분석 77
• 제 5 장 결 론 90
• 참 고 문 헌 98
• 초록(Abstract) 112