中国地方政府医疗卫生支出效率及其影响因素研究——以中部六省为例

Research on the Efficiency and Influencing Factors of Provincial Government Health Expenditure——A Case Study of Six Central Provinces in China

医疗卫生事业关系亿万人民群众的健康福祉,是一项举足轻重的民生工程,而公共医疗卫生支出的效率关系人民群众的生命健康。文章在DEA—Tobit两阶段分析的框架下,选用2008—2017年中部六省的面板数据,研究了中部地区的医疗卫生支出效率及其影响因素,应用非参数数据包络分析(DEA)方法测算各省政府医疗卫生支出的综合技术效率、纯技术效率和规模效率,通过Malmquist生产率指数分析了医疗卫生支出效率的动态变化,并利用受限因变量Tobit模型对效率评价结果及其影响因素之间的关系做实证分析。研究结果表明:中部六省的财政医疗卫生支出效率存在明显的异质性,而决定效率差异的核心因素为财政分权指标。

Public health service greatly matters people's well-being.The efficiency of expenditure on public health care is directly related to the lives and health of the people.Within the framework of DEA-Tobit two-stage analysis,this paper uses panel data from 2008 to 2017 of six provinces in central China to study the efficiency of expenditure on health and its influencing factors,as well as the method of non-parametric data envelopment analysis(DEA)to measure comprehensive technical efficiency,pure technical efficiency and scale efficiency of provincial government expenditure on health.This study analyzes the dynamic changes of the efficiency of health care expenditure through Malmquist Productivity Index and empirically analyze results of efficiency evaluation and the relationship between the results and the influencing factors on efficiency by using a restricted dependent variable panel Tobit model.The result shows that the efficiency of government health expenditure in the six central provinces presents obvious regional heterogeneity.The index of fiscal decentralization is the fundamental factor causing the difference in efficiency.