Whether fiscal decentralization helps to provide public services that match local residents’preference remains inconclusive .By virtue of the quasi natural experiment of “county administrated by province” reform ,this paper aims to investigate the impact of local decentralization on the improvement of public services from a perspective of micro de‐mand .It makes an empirical analysis of the relationship between “county administrated by province” reform and public medical services satisfaction by using the county -level macro data in 2005 and CGSS2005 micro survey .Logit model results show that the implementa‐tion of “county administrated by province” system has failed to make local governments provide residents with more satisfying medical services ,but worsens residents’satisfaction on public medical services .After excluding the interference of “reform illusion” ,“expecta‐tion effect” and “lag effect” ,the conclusions still remain robust .T his paper argues that the expansion of economic rights intensifies local government competition ,and offers local governments with greater incentives to use fiscal funds in infrastructure field rather than people’s livelihood field ,leading to relatively insufficient supply of medical services and thereby the reduction in satisfaction .The medium analysis confirms the inference .It is beneficial to the analysis of public welfare effect of fiscal decentralization reform from a micro perspective .%财政分权是否有助于提高与本地居民偏好更加匹配的公共服务水平未有定论。借助“省管县”改革这一准自然实验，文章旨在从微观需求角度考察地方分权对公共服务改善的效果。采用2005年的县级宏观数据和 CG S S2005居民调查数据，本文对“省管县”改革与公共医疗服务满意度的关系进行了实证分析。 Logit模型结果表明，“省管县”财政体制的实施未能使当地政府提供让居民更加合意的医疗服务，反而恶化了居民对公共医疗服务的满意度。在排除了“改革错觉”、“预期效应”以及“滞后效应”的干扰后，这一结论依旧稳健。文章认为，财权扩大加剧了地方政府间竞争，使得县级政府有更大的激励将财政资金投入到基建领域而非民生领域，这将导致医疗服务供给相对不足，进而引起满意度的下降。中介分析证实了这一推理。文章研究有助于从微观视角评析分权改革的公共福利效应。
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