本研究利用15個OECD國家在1990至2006年間的追蹤資料，重新檢測影響實質人均醫療支出的決定性因素。在控制國家與年度固定效果後，探討所得、需求面因素（老年人口、平均住院天數）、供給面因素（醫師數密度）及公部門籌資比例等變數對醫療支出成長的影響。此外，在考量所得因素可能潛在的內生性問題下，本研究也使用兩階段分量迴歸方法，以衡量上述解釋變數在不同醫療支出分配下的異質性影響。

研究結果發現:（1）醫療支出所得彈性小於一，因此支持醫療保健為必需品而非奢侈品的結論。（2）GDP對醫療支出的影響隨著分量右移而遞減，在高分量（0.85分量）則不顯著。（3）老年化變數對醫療支出的影響至中分量後開始顯著。（4）平均住院天數對醫療支出的影響在各分量下皆為顯著。（5）醫師密度對醫療支出的影響在各分量下皆為顯著，但影響幅度隨著分量右移而呈現遞減的現象。（6）公部門籌資比例與醫療支出的正向關係，與公共選擇理論的概念相符；影響幅度在低分量（0.15分量）為最大，但隨著分量右移而遞減。（7）特別的是，二階段分量迴歸顯示，在GDP的影響幅度被工具變數沖銷後，公部門籌資比例成為影響醫療支出的最主要因素。

Abstract
By using the panel data from 1990 to 2006 over 15 OECD countries, this study re-examines the growth of health expenditures by assessing the impact of income, demand side factor（aging population、average length of inpatient stay）, supply side factor（density of physicians）, and ratio of public financing on real health expenditures per capita after controlling country and year fixed effects. Furthermore, this study also uses the two-stage quantile regression to address the potential problem of income and the heterogeneity of conditional distribution.
The findings show that:（1）the income elasticity is less than one and suggests that health care is necessary rather than luxury;（2）the impact of GDP likely decreases over quantiles, except the 85th quantile with an insignificant coefficient ;（3）at the middle quantile（q0.5）, aging population presents the significant effect ;（4）the average length of inpatient stay has significant impact over all quantiles ;（5）the impact of density of physicians is statistically significant over all quantiles, but this effect decreases in higher level quantiles.（6）the effect of ratio of public financing is expenditure-increasing. This effect is the highest at the 15th quantile but decreases over higher level quantiles ;（7）specifically, the ratio of public financing becomes the major factor after the impact of GDP drop by the instrument variable at the two-stage quantile regression.

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