我国医疗卫生效率的区域差异及其动态演进研究——基于两阶段视角的实证分析

Study on Regional Differences and Dynamic Evolution of Medical and Health Efficiency in China--Empirical Analysis Based on Two-stage Perspective

目的:从两阶段视角出发,测算我国各省(区、市)医疗卫生效率,提出促进效率提升的政策建议。方法:基于2009—2017年面板数据,采用DEA-BCC模型、Malmquist指数模型测算各省(区、市)医疗卫生效率、全要素生产率,综合比较省际间、区域间、阶段间的效率差异并进行动态跨期评价。结果:我国整体医疗卫生资源配置综合效率呈上升态势,但存在明显的区域差异,中部最高、西部次之、东部最低,全要素生产率指数省际差距在不断减小并呈下降趋势;我国整体医疗卫生服务运行综合效率走势呈“N”型,东部最高、西部次之、中部最低,全要素生产率指数集中且连片特征日益凸显。结论:正视区域差异,鼓励技术创新,优化资源配置,推动医疗卫生事业协调发展。

Objective To measure the medical and health efficiency of various provinces(districts and cities)in China from a two-stage perspective.Methods Based on the panel data from 2009 to 2017,DEA-BCC model and Malmquist index model were used to measure the medical and health efficiency and total factor productivity of each province(districts and city).The efficiency differences among provinces,regions and stages were comprehensively compared and dynamic intertemporal evaluation among them was carried out.Results The comprehensive efficiency of overall medical and health resource allocation in China showed an upward trend,but there were obvious regional differences,with the highest in the middle,the second in the west and the lowest in the east.The inter-provincial gap of total factor productivity index is decreasing and showing a downward trend.The overall operation efficiency of medical and health services in China shows an"N"type,with the highest in the east,the second in the west and the lowest in the middle.The total factor productivity index is concentrated and continuous characteristics are becoming increasingly prominent.Conclusion It is necessary to envisage regional differences,encourage technological innovation,optimize the resources allocation,and promote the coordinated development of medical and health undertakings.