新医改背景下广州市城乡基层医疗卫生服务体系效率研究

Comparative Study on Service Efficiency of Guangzhou's Urban and Rural Health Care Systems in Health Care Reform

目的:评价新医改以来广州市城乡基层医疗卫生服务体系服务效率。方法:采用DEA-Malmquist指数分析方法研究广州市2009-2013年城乡基层医疗卫生机构全要素生产率及分解因素。结果:2009-2013年基本医疗服务全要素生产率年平均下降0.2%,技术进步下降0.3%,城乡有显著性差异;技术效率年平均下降0.4%,纯技术效率年平均上升1.5%,规模效率年平均下降1.9%。公共卫生服务全要素生产率年平均上升18.1%,技术进步上升18.6%;技术效率年平均下降0.4%,纯技术效率年平均上升1.5%,规模效率年平均下降1.9%。结论:新医改以来,广州市城乡基层医疗卫生服务体系服务效率变化是不平衡的。

Objective： Explored and assessed the efficiency of Guangzhoug urban and rural health care systems. Methods： Through a non-parametric Malmquist index approach, this paper had analyzed total factor productivity change in Guangzhou＇s township hospital and community health service with panel data from 2009 to 2013. Results： From 2009 to 2013, the average growth rate of total factor productivity in Guangzhou urban and rural health care systems in basic health service was -0.2% , and the technology improvement was -0. 3% , the difference between urban and rural area was significant. The average growth rate of technical productivity was -0.4% , the pure technical productivity was 1.5% , while the scale productivity was - 1.9%. The average growth rate of total factor productivity in Guangzhou＇s urban and rural health care systems in public health service was 18. 1%, and the technology improvement was 18.6%. The average growth rate of technical productivity was -0.4%, the pure technical productivity was 1.5%, while the scale productivity was -1.9%. Conclusion： The public health service efficiency measurement showed that the gap between urban and rural health care systems was not so big. However, the basic medical service efficiency of rural township hospitals was significantly lower than that of the urban community health service centers.