基于三阶段SBM-Malmquist模型的中国医疗卫生资源配置效率分析

Efficiency analysis of medical and health resource allocation in China based on three-stage SBM-Malmquist model

文章基于三阶段SBM模型、Malmquist指数法,对2015—2020年我国31个省(自治区、直辖市,除港澳台地区)医疗卫生资源配置效率进行静态与动态评价。结果显示,剔除环境因素与随机误差后,2015—2020年我国卫生资源配置综合效率均值为0.720,全要素生产率均值为0.937,其中技术进步指数、纯技术效率变化指数、规模效率变化指数分别下降5.4%、0.7%、0.3%。2015—2020年我国卫生资源配置效率整体偏低,呈下降趋势,技术进步制约明显;地域间、省际配置效率差异较大;各地区生产总值、常住人口数及城市化水平显著影响配置效率。建议以适宜发展规模为基础、以技术进步为动力,实现效率提升;以区域协调为重点,增强卫生资源投入均衡性、公平性、精准性;以改善外部环境为突破口,健全医疗卫生服务体系。

Based on the three-stage SBM model and the Malmquist index method,the article conducted static and dynamic evaluation of the allocation efficiency of medical and health resources in 31 provinces and cities(excluding Hong Kong,Macao and Taiwan regions) in China from 2015 to 2020. The results showed that after eliminating environmental factors and random errors,the average comprehensive efficiency of health resource allocation in China from 2015 to 2020 was 0.720,and the average total factor productivity was 0.937.Among them,the technological progress index decreased by 5.4%,the pure technical efficiency change index decreased by 0.7%,and the scale efficiency change index decreased by 0.3%. From 2015 to 2020,the overall efficiency of health resource allocation in China is low and on a downward trend,with obvious constraints on technological progress. There are large differences in the allocation efficiency between regions and provinces;regional gross domestic product,resident population and urbanization levels have a significant impact on allocation efficiency. It is suggested to improve efficiency based on appropriate development scale and driven by technological progress;focusing on regional coordination,enhancing the balance,fairness and accuracy of health resource input;and using the improvement of the external environment as a breakthrough,to improve the health service system.