广东省公共卫生支出效率及其影响因素研究

A Study on Efficiency and Influencing Factors of Guangdong's Public Health Expenditure

在DEA-Tobit两阶段分析框架下,利用数据包络分析方法测算广东省21个地级市2003-2012年公共卫生支出的综合技术效率、纯技术效率和规模效率。研究发现,2003-2012年间广东省公共卫生支出效率平均水平偏低,在0.58-0.8范围内波动,且整体呈下降趋势;各地级市卫生支出效率存在显著差异,卫生支出处于中低水平的地区与高水平的广州、深圳两地相比,综合效率值更高。进一步地,采用受限因变量模型研究影响卫生支出效率的因素,发现财政分权、医疗卫生政策、城市化水平和经济发展水平等因素与卫生支出效率呈负相关关系,人口密度、教育水平与其呈正相关系。基于结论,对提高广东省公共卫生支出效率提出相关建议。

Under the two - stage framework of DEA - Tobit, 21 Guangdong municipal cities＇ public health expenditure efficiencies from 2003 to 2012 are calculated by using Data Envelopment Analysis （DEA） approach, including the composite technical efficiency, pure technical efficiency and the scale efficiency. It finds that the average public health expenditure efficiency was low during the year 2003 to 2012, and the data fluctuated from 0. 58 to 0. 8 and experienced a descending trend. The efficiencies vary in different cities; Re- gions like Guangzhou and Shenzhen with a high - level public health expenditure have lower composite techni- cal efficiencies than those with a middle or low - level expenditure. Based on the efficiency scores calculated, a limited dependent variable Tobit model is used to study the relationship between composite technical efficien- cy and the influencing factors. The results show that fiscal decentralization, medical policy, urbanization level and economic growth ratio have negative impacts on efficiency, while education level and population density are positively correlated with efficiency. Finally, some suggestions are presented to improve the public health expenditure efficiency of Guangdong.