新医改以来宁夏回族自治区市级财政医疗卫生支出动态效率测量

Measurement of Dynamic Efficiency of Medical and Health Expenditure in Ningxia Municipal Finance Since the New Medical Reform

目的测量新医改以来宁夏回族自治区市级财政医疗卫生支出的动态效率,为改进政府卫生支出的配置效率提出建议。方法收集宁夏回族自治区5个地级市2010—2017年财政医疗卫生支出及医疗机构床位数等产出指标的面板数据,运用DEA三阶段模型修正Malmquist指数法测算其动态效率。结果通过比较修正前后Malmquist指数发现宁夏回族自治区5市财政医疗卫生支出动态效率整体上表现出衰退的趋势[全要素生产率(TFP)=0.973],仅有中卫市处于增长状态(TFP=1.021),银川市最低(TFP=0.914);5市规模效率均处于增长状态[规模效率(SEC)=1.074],但技术进步效率均表现出衰退(TC=0.915<1)。结论宁夏政府在医疗卫生支出效率改进方面应关注由技术进步衰退所导致的效率降低,鼓励医疗创新以及向经济不发达地区进一步下沉优势资源。

Objective To measure the dynamic efficiency of Ningxia municipal financial medical and health expenditure since the new medical reform,and put forward some suggestions for improving the allocation efficiency of government health expenditure.Methods Panel data of output indicators such as fiscal medical and health expenditures and the number of beds in medical institutions in 5 prefecture-level cities in Ningxia from 2010 to 2017 was collected,and DEA three-stage model was used to modify the Malmquist index method to measure their dynamic efficiency.Results By comparing the Malmquist index before and after the correction,it is found that the dynamic efficiency of financial medical and health expenditures in the five cities of Ningxia has shown a downward trend(TFP=0.973).Only Zhongwei City was in a growth state(TFP=1.021),and Yinchuan City is the lowest(TFP=0.914);The scale and efficiency of the 5 cities were all increasing(SEC=1.074),but the efficiency of technological progress has shown a decline(TC=0.915<1).Conclusion In terms of improving the efficiency of medical and health expenditure,the Ningxia government should pay attention to the decline in efficiency caused by technological progress,encourage medical innovation and further sink superior resources to economically underdeveloped areas.