中国省级公共医疗卫生支出效率动态评价研究——基于医药卫生体制改革视角

A Study of Dynamic Evaluation on The Efficiency of Provincial Public Healthcare Expenditure in China-Based on The Perspective of Health System Reform

实现有限财税资源的高效利用与产出最大化是各国政府均面临的挑战。通过构建以数据包络分析为核心的四阶段分析框架,对中国2007—2011年30个省市公共医疗卫生投入与产出的面板数据进行技术变动、纯技术与规模效率的核算及其变动的动态评价研究表明:在控制环境因素与随机冲击影响的条件下,省级公共医疗卫生支出年均存在29.5%的效率损失。2009年启动的医药卫生体制改革给予全国范围内医疗卫生支出效率的技术进步推动力在2010年达到峰值后走出下降趋势,并且区域差异特征明显。结合当前财税体制改革,提出了建立跨区域转移支付制度等三项有针对性的政策建议。

Governments around the world are facing challenges achieving efficient use and maximizing output of their limited fiscal resources. By building and using a four stages analysis framework, of which the data envelopment analysis is as the core, the dynamic measuring study has been carried out on the technical change, pure technical and scale efficiency change of a public health inputs and outputs panel data of 30 provinces in China during the period from 2007 to 2011. In the conditions of controlling environmental factors and random shocks, the conclusion shows that there is 29.5% average annum loss of the efficiency in Provincial public healthcare expenditure. The improvement of the efficiency and technological advances impetus, provided nationwide by healthcare reform since 2009, have reached the peak in 2010 and then has been out of a downward trend with obvious different regional characteristics. Combing with the current reform of fiscal and tax system, three targeted policy recommendations will be proposed, such as the establishment of interregional transfer payment system.