湖南省医疗卫生资源配置效率分析———基于数据包络分析VRS模型与Malmquist指数模型

Efficiency of health resources allocation in Hunan Province-based on VRS model and Malmquist index model of data envelopment analysis

目的基于区域协调发展视角,分析2010—2020年湖南省及四大区域的卫生资源配置效率情况,为湖南省各区域提升卫生资源配置效率、促进卫生健康事业协调发展提供理论参考。方法采用数据包络分析(data envelopment analysis,DEA)中的基于规模收益可变(variable returns to scale,VRS)模型和Malmquist指数模型对2010—2020年湖南省卫生资源配置效率进行分析。结果2020年湖南省千人口卫生技术人员数达7.52人,千人口床位数达7.82张。2010—2020年间湖南省卫生资源配置综合效率逐年下降,2020年湖南省整体卫生资源配置的综合效率、纯技术效率和规模效率值分别为0.685、0.951、0.721,14个市州中,3个市为卫生资源配置DEA有效(21.4%),1个市为DEA弱有效(7.1%)。2010—2020年,长株潭城市群、湘南地区、洞庭湖经济区、湘西地区四大区域的全要素生产率变化指数均值分别为0.963、0.916、0.905、0.924,全省均值为0.926。结论湖南省医疗卫生资源投入持续增加,但区域配置和资源结构合理性有待提升;整体卫生资源配置效率有待提高,重点在于提升规模效率和技术水平;各地区卫生资源配置效率有差异,且影响因素多元,可探索建立区域内和区域间协调发展机制,因地制宜优化卫生资源配置方式。

Objective To analyze the efficiency of health resources allocation in Hunan Province as well as its four regions from 2010 to 2020 based on the perspective of coordinated regional development,and to provide theoretical references for improving the efficiency of health resources allocation in all regions of Hunan Province and promoting the coordinated development of medical and health undertakings.Methods The efficiency of health resources allocation in Hunan Province from 2010 to 2020 was analyzed by using the variable returns to scale(VRS)model and Malmquist index model in data envelopment analysis(DEA).Results In 2020,there were 7.52 health technicians and 7.82 beds for 1,000 persons in Hunan Province.From 2010 to 2020,the comprehensive efficiency of health resources allocation in Hunan Province decreased year by year.The values of comprehensive efficiency,pure technical efficiency and scale efficiency of overall health resources allocation in Hunan Province in 2020 were 0.685,0.951 and 0.721,respectively.Among the 14 cities and prefectures,3 cities were efficient in DEA allocation of health resources(21.4%),and 1 city was weakly efficient(7.1%).From 2010 to 2020,the average total factor productivity change index values of the four major regions,Changzhutan urban agglomeration,Xiangnan region,Dongting Lake Economic Zone and Xiangxi region were 0.963,0.916,0.905 and 0.924,respectively,and the provincial average value was 0.926.Conclusion The investment of medical and health resources in Hunan Province continues to increase,but the rationality of regional allocation and resource structure needs to be improved.The overall efficiency of health resources allocation needs to be raised,with the emphasis on improving scale efficiency and technical level.There are differences in the efficiency of health resources allocation in different regions,and the influencing factors are diverse.Therefore,it is possible to explore the establishment of intra-regional and inter-regional coordinated development mechanisms and optimize the allocation of health resources according to local conditions.