我国超特大城市卫生资源配置效率与水平对比研究

Comparative study on the efficiency and level of health resources allocation based on megacities and megalopolis in China

目的探究我国6个超大城市和11个特大城市卫生资源配置效率与水平的差异,为优化卫生资源配置提供参考。方法采用数据包络分析法(data envelopment analysis,DEA)评价各城市卫生资源配置效率,并用因子分析法比较各城市医疗资源数量与水平。结果数据包络分析结果显示,6个城市DEA有效,1个城市DEA弱有效,10个城市DEA无效,除广州属于“双高型”城市外,其他超大城市均为有效或弱有效。因子分析结果显示各地区卫生资源配置水平不同,排名前五的是北京(1.379)、杭州(0.553)、郑州(0.474)、西安(0.42)、广州(0.415),排名倒数五个城市是苏州(-0.564)、天津(-0.64)、重庆(-0.661)、深圳(-0.853)、东莞(-1.156)。结论各大城市卫生资源配置效率存在显著差异,城镇化水平较高的城市,其卫生资源配置效率较高,但卫生基础资源配置因子得分较低;而综合医疗实力强度因子得分较高的城市均为老牌大城市,即北京、上海、广州和天津。综合对比分析,发现我国超特大城市医疗卫生资源配置存在的问题和不足,进而提出完善我国卫生资源配置的政策建议。

Objective To explore the differences in the efficiency and level of health resources allocation between 6 megacities and 11 megalopolis and their mutual influences in China in 2019 so as to provide evidences for policymaking.Methods The data envelopment analysis method was used to analyze the efficiency of megacities and megalopolis health resource allocation.Factor Analysis was used to compare the quantity and level of medical resources in different cities.Results The comparison of data envelopment analysis in 2019 showed that the health resource allocation efficiency of 6 cities were DEA effective,1 city was weakly DEA effective,and 10 cities were non-DEA effective.Except Guangzhou,which belongs to“double-high”type city,other megacities are effective or weakly effective.The results of Factor Analysis showed that the level of health resource allocation was different in each region.The top 5 cities with a higher comprehensive score of health resource allocation were Beijing(1.379),Hangzhou(0.553),Zhengzhou(0.474),Xi’an(0.42)and Guangzhou(0.415).The last 5 cities with a lower score of health resource allocation were Suzhou(-0.564),Tianjin(-0.64),Chongqing(-0.661),Shenzhen(-0.853)and Dongguan(-1.156).Conclusion There are significant differences in the efficiency of health resource allocation in different cities.The cities with higher urbanization level have higher efficiency of health resource allocation,but lower scores of basic health resource allocation factor.The cities with higher scores in comprehensive medical strength intensity factor are all old big cities,namely Beijing,Shanghai,Guangzhou and Tianjin.