2015—2020年广西边境地区乡镇卫生院的卫生资源配置效率——基于Malmquist指数模型的研究

Efficiency of health resource allocation of township health centers in Guangxi frontier areas from 2015 to 2020:a study based on Malmquist index model

目的基于Malmquist指数模型分析2015—2020年广西边境地区乡镇卫生院的卫生资源配置效率。方法选取广西东兴市、那坡县、靖西市、宁明县、龙州县、大新县和凭祥市7个边境县(市)的全部乡镇卫生院作为研究对象,选取执业(助理)医师数、注册护士数和床位数作为投入指标,总诊疗人次、入院人数和病床使用率作为产出指标,运用Malmquist指数模型对2015—2020年广西边境地区乡镇卫生院的卫生资源配置效率进行分析。结果2015—2020年,广西7个边境县(市)的乡镇卫生院平均每千人口执业(助理)医师数、注册护士数和床位数均呈增长趋势,但均低于同期广西乡镇卫生院平均水平;不同边境县(市)之间乡镇卫生院每千人口执业(助理)医师数、注册护士数和床位数存在差异。2015—2020年,广西7个边境县(市)乡镇卫生院的全要素生产率变动(TFP)指数均值为0.963,技术效率变化指数均值为1.005,技术进步变化指数均值为0.958,纯技术效率变化指数均值为1.002,规模效率指数均值为1.003。广西7个边境县(市)中,有6个县(市)乡镇卫生院的TFP指数小于1。结论广西边境地区乡镇卫生院的卫生资源逐年增加,但卫生人力总量相对不足,卫生配置效率总体不高,县域间卫生资源配置水平存在差异。乡镇卫生院资源技术进步不足是限制广西边境地区乡镇卫生院投入产出效率的关键因素。

Objective To analyze the efficiency of health resource allocation of township health centers in Guangxi frontier areas form 2015 to 2020 based on Malmquist index model.Methods All township health centers in seven frontier counties(cities)in Guangxi,namely,Dongxing,Napo,Jingxi,Ningming,Longzhou,Daxin and Pingxiang,were selected as the research objects.The number of practicing(assistant)physicians,registered nurses and beds were selected as the input indicators,and the total person-time of hospital visits,number of admissions and bed utilization rate as the output indicators.The Malmquist index model was used to analyze the health resource allocation efficiency of township health centers in frontier areas of Guangxi from 2015 to 2020.Results From 2015 to 2020,the average number of practicing(assistant)physicians,registered nurses and beds per 1000 population of township health centers in 7 frontier counties(cities)of Guangxi exhibited an increasing trend,but they were all lower than the average level of township health centers of Guangxi during the same period.There were differences in the number of practicing(assistant)physicians,registered nurses and beds per 1000 population at township health centers between different frontier counties(cities).From 2015 to 2020,the average value of total factor productivity(TFP)index of township health centers in 7 frontier counties(cities)of Guangxi was 0.963,the average value of technical efficiency change index was 1.005,the average value of technological change index was 0.958,and the average value of pure technical efficiency index was 1.002,as well as the average value of scale efficiency index was 1.003.Among the 7 frontier counties(cities)in Guangxi,the TFP index of township health centers in 6 counties(cities)was less than 1.Conclusion The health resources of township health centers in frontier areas increase year by year,but the total health manpower is relatively insufficient,health allocation efficiency is generally low,and the level of health resource allocation is different among counties in Guangxi.Insufficient resource and technology progress of township health centers is the key factor in limiting the input-output efficiency of township health centers in frontier areas of Guangxi.