基于链式模型的省际卫生总费用健康效率研究

Research on Health Efficiency of China’s Provincial Total Health Expenditure Based on Chain Model

目的:测算和分析2013—2017年我国省际卫生总费用的健康产出效率,为控制卫生费用过快增长及构建整合型医疗卫生体系提供参考。方法:首先基于链式模型构建子链,然后采用数据包络分析法(DEA)从静态角度测算子链至总链的综合、技术与规模效率,最后运用Malmquist指数对五年间卫生总费用的健康产出效率做出动态评价。结果:2017年我国卫生总费用健康综合效率、纯技术效率与规模效率分别达到0.712 7、0.861 7、0.827 2,5年间Malmquist指数的总体水平均大于1,增长幅度为5.12%~11.16%。结论:5年来我国卫生总费用相邻时期健康产出效率持续改进,但当期卫生总费用健康效率不高,省际差异明显。

Objective: To calculate and analyze the health output efficiency of China’s inter-provincial total health expenditure (THE) from 2013 to 2017, so as to provide references for controlling the excessive growth of health expenditure and building an integrated medical and health system. Methods: Firstly, the sub-chain was constructed based on the chain model;then the data envelopment analysis (DEA) was used to measure the integration, technology and scale efficiency of the sub-chain to the total chain from a static perspective;finally, the malmquist index was used to make a dynamic evaluation of the health output efficiency of the THE for 5 years. Results: In 2017, the overall health efficiency, pure technical efficiency and scale efficiency of China are THE reached to 0.7 127, 0.8 617, and 0.8 272, respectively. The overall level of the total factor productivity change index was greater than 1 in the five years, with a growth rate ranged from 5.12% to 11.16%. Conclusion: In the past 5 years, the health output efficiency of China’s THE had been continuously improved in the adjacent period, but the THE of the current period was not high and the inter-provincial differences were obvious.