纳入需求方因素的中国农村医疗机构服务效率——基于三省18县的医疗机构与入户调研数据分析

Efficiency of Institutional Health Care Service in Rural China Taking Account of Demand-Side Factors:Empirical Study Based on the Survey of Three Provinces

我国医疗资源的城乡分布不平等,亟需农村地区有效利用有限资源提供最大化的医疗卫生服务。本文基于甘肃、河南、广东三省18个县的家庭入户调研和医疗机构调研数据,运用四步DEA方法,在考虑医疗需求方因素的基础上,对我国农村医疗机构的服务效率及其影响因素进行分析。实证结果发现,地区性的医疗支付能力与医疗机构服务效率有密切关系,医疗机构内部因素对效率起到关键性的影响,县乡两级医疗机构的效率存在较大差异,且影响机制也有所不同。最后,本文结合实证分析结果对提高农村地区医疗服务效率的政策进行了讨论。

Efficiency improvement in rural healthcare institutions is required, due to imbalance of healthcare resources allocation between urban and rural area. In this paper, the efficiency of healthcare institutions is analyzed, based on data collected in 18 counties of three provinces. Taking demand-side factors into account, a four-step DEA method is used for efficiency analy- sis. Obtained empirical results show that affordability of medical service and efficiency of the local medical institutions are closely related. Institutional characteristics of healthcare institution can have a great impact on its efficiency. Difference of efficiency between healthcare institution of county area and of town area is estimated to be massive. Potential policy for efficiency im- provement in rural healthcare institution is discussed in the end.