基于DEA模型与面板Tobit的我国公共卫生资源配置效率研究

A study on public health resource allocation efficiency in China:Based on DEA model and Panel Tobit

在“大卫生、大健康”的背景下,随着公共卫生支出和需求的不断增加,如何公平、高效的配置公共卫生资源成为政府亟待解决的重要问题。本文基于2013—2020年全国31个省域的相关指标数据,首先采用投入导向的三阶段DEA模型对我国公共卫生资源的整体和分地区配置效率进行测算,并构建提出外部环境因素和随机误差的Malmquist生产率指数对配置效率进行动态评价;此后基于受限随机效应面板Tobit模型检验外部经济因素和人口特征对公共卫生资源配置效率的影响。研究结果显示,我国各地区公共卫生资源整体配置效率过低主要是由于规模效率不高所致,而历年配置效率的生产率表明,技术进步是制约其提升的主要原因,经济发展水平是促进公共卫生资源配置效率优化的重要因素,而过大的投入规模则是阻碍公共卫生资源配置效率优化的关键因素。相对于其他人口学特征,地区内的老年人口比重对于公共卫生资源优化配置效率具有更为显著的影响。最后,本文据此提出一系列优化我国公共卫生资源配置效率的政策建议。

With the continuous increase of public health expenditure and demand,how to allocate public health resources fairly and efficiently has become an important issue for the Chinese government that urgently awaits a solution under the background of Great Health.Taking advantage of related index data from 31 provinces and regions of China during the years of 2013—2020,this paper first used input-oriented three-stage DEA model to evaluate the overall and regional allocation efficiency of public health resources in China,and dynamically reviewed the allocation efficiency by constructing Malmquist productivity index with environmental factors and random errors excluded;then,the work tested the impact of external economic factors and population characteristics on the overall allocation efficiency of public health resources by using the restricted random effect Panel Tobit model.The results showed that the main reason of low overall allocation efficiency across all regions of China is due to the low level of scale efficiency.Meanwhile,the productivity of allocation efficiency over the years showed that technological progress is the main reason that restricted its improvement,and the level of economic development is a major factor for promoting the optimization of public health resource allocation efficiency,whereas an excessive scale of investment is a key impeding factor of this optimization.Compared with other population characteristics,it was found that the proportion of the elderly population in a region has a more significant impact on the optimization of public health resource allocation efficiency.Finally,this paper put forward a series of suggested policies for optimizing the public health resource allocation efficiency of China.