新医改实施以来我国各类医疗卫生机构资源配置效率的变动分析——基于DEA和Malmquist指数方法的实证研究

The change of resource allocation efficiency of various medical and health institutions in China since the new medical reform——Empirical study based on DEA and Malmquist index method

文章在基于BCC-CCR和Malmquist指数模型实证测算2009-2017年我国各类医疗卫生机构的资源配置效率时发现:医院、基层医疗卫生机构、专业公共卫生机构资源配置效率DEA有效的年份为七年、五年和七年,各自占比77.78%、55.56%以及77.78%,全要素生产效率变动均值分别为0.982、0.993、0.975,新医改政策实施对我国医疗卫生机构资源配置效率的改善并不显著。进一步研究表明:我国各类医疗卫生机构资源配置效率非DEA有效的主要原因在于技术与规模投入不足或规模投入过剩,全要素生产效率指数的总体变动主要受技术变化指数影响,与技术效率变动、纯技术效率变动以及规模效率变动指数无关。为此,应加大医疗卫生技术投入、推动医疗卫生技术革新,合理控制医疗资源投入规模、逐步实现规模产出最大化,优化医疗卫生资源配置结构,着力增强基层医疗卫生机构和专业公共卫生机构资源配置效率,从而改善医疗卫生机构整体效率,进一步提升新医改政策实施成效。

Based on the BCC-CCR and Malmquist index model,which estimates,with empirical data,2009-2017 various types of medical institutions in China,this research found that the DEA efficient resource allocation efficiency of the hospital,grassroots medical and health institutions,professional public health agencies are 7 years,5 years and 7 years,accounted for 77.78%,55.56% and 77.78%respectively.The mean value of total factor productivity change is 0.982,0.993,0.975,respectively.The new health care reform policy of our country medical institutions fails to significantly improve the efficiency of resources disposition.Further analysis shows that the main reasons for non DEA efficient resource allocation efficiency of all kinds of medical institutions in China lie in technology and the inadequate or surplus input scale.Total factor productivity index changes was mainly affected by technological change index,but not affected by changes in technical efficiency,pure technical efficiency change,or scale efficiency change index.Therefore,we should increase investment in health care technology,promote medical and health innovation,control the scale of medical resources and gradually realize the maximization of the scale of output to optimize health resources allocation structure,strengthen basic medical and health institutions and professional organization of public health resources allocation efficiency.