中国医疗卫生服务供给水平的地区差异及空间收敛性研究

Research on Regional Difference and Spatial Convergence of Medical and Health Service Supply in China

文章通过构建医疗卫生服务供给评价指标体系,利用2007~2017年中国省级面板数据,采用熵权法合成单一化指数,刻画各省医疗卫生服务供给水平。在此基础上,运用核密度估计图、Dagum基尼系数对其分布动态演进过程、地区差异及来源进行探析,借助变异系数法、空间杜宾模型和MLE估计法揭示其σ收敛和β收敛特征。研究结果表明:(1)全国及东、中、西部三大区域医疗卫生服务供给水平均呈稳步上升态势,但全国与中部区域表现出不同程度的梯度效应,具有多极和两极分化现象,而东部和西部区域则均不存在明显分化现象。(2)总体差异、区域内差异及区域间差异均呈减弱趋势,其中区域间差异对总体差异贡献占比最大,区域内差异和超变密度贡献占比较小。(3)全国整体与三大区域医疗卫生服务供给水平差异演变趋势既存在σ收敛特征,也存在绝对β收敛和条件β收敛特征,且都在β收敛中呈现显著的空间溢出效应。最后,依据研究结论,文章提出相关政策建议。

By constructing the evaluation index system of medical and health service supply, and using the inter-provincial panel data of China from 2007 to 2017, the paper uses entropy weight method to measure the medical and health service supply in each province. It analyzes dynamics of the distribution, regional differences and different sources of medcial/health service supply using kernel density estimation graph, Dagum Gini coefficient, α convergence and β convergence characteristics. The research shows that:(1) The medical and health service supply in the whole country and those in the three regions(east, middle and west) show a steady upward trend. However, the national trend and that in the middle region show some gradients and are multi-modal or polarized, while the trends in eastern and western regions do not have obvious polarization.(2) The overall difference, intra-regional differences and inter-regional differences all weaken over time. The overall difference is mainly attributed to the regional difference, while the intra-regional difference and super-variable density are smaller, ranking the second and third in their contributions.(3) There is evidence not only of α convergence, but also of β convergence, absolute and conditional, in the dynamics of the medical and health service supply. And there are significant spatial spillover effects in their convergence. The paper provides relevant policy suggestions in the conclusive remark.