中国农村医疗服务效率测度、演进趋势及改革启示

Measurement and Trend Evolution of Medical Service Efficiency in Rural China

根据SBM-DEA超效率模型测算2010-2019年中国各省份的农村医疗服务效率,采用Dagum基尼系数和Kernel核密度探究各省份农村医疗服务效率的时空差异与演进趋势.研究发现:①中国农村医疗服务效率整体呈下降趋势,年均下降2.37%.②分区域而言,东部地区农村医疗服务效率最高,中部次之,西部最低.③我国总体农村医疗服务效率的差异不明显;就各区域内而言,东部地区内部医疗服务效率差异最大;就区域间差异而言,东、西部之间的医疗服务效率差异最大.④就绝对差距而言,东部、中部地区区域内绝对差距逐渐增大,而西部地区区域内绝对差距逐渐缩小.该文以“提高各省农村医疗服务效率、缩小地区间农村医疗服务效率差距”为切入点,提出“改变农民就医行为、健全农村医疗服务体系、提升省内医疗资源配置效率、推动区域间经验交流学习”等应对策略,以期提高农村医疗服务效率.

In this paper,we use the SBM-DEA super-efficiency model with undesirable outputs to estimate the efficiency of rural medical services of the provinces in China from 2010 to 2019,and then use Dagum Gini coefficient and Kernel density to explore the spatial and temporal differences and dynamic evolution of the efficiency of rural medical services of the provinces.The study found that:First,the efficiency of rural medical services in China was declining,and the efficiency of rural medical services in the western region declined the most.Second,at the national level,the Gini coefficient of rural medical service efficiency fluctuated sharply,but the overall gap was not large.The regional differences of rural medical public service mainly came from the ultra-variable density,and its contribution rate fluctuated greatly.Third,the overall difference of rural medical services in China showed a trend of decreasing first,then increasing,and the gap of rural medical services efficiency among provinces changed fiercely.In recent years,the absolute gap within the region in the eastern and central regions was obvious,while the absolute gap in the western region has weakened.This study has important reference significance for the formulation and implementation of relevant policies and regulations,such as hierarchical classification to improve the efficiency of rural medical services and promote the equalization of urban and rural medical services.