医联体基层医疗卫生资源配置效应及优化路径研究

Research on the allocation effect and optimization path of grassroots level medical and health resources in Medical Cluster

目的:研究医联体对基层医疗卫生资源配置效率的影响,并解释其内在作用机制,为医联体“强基层”提供优化路径。方法:运用DEA-Malmquist指数模型测算某直辖市基层医疗卫生资源配置效率的变动情况,并通过倾向得分匹配法(PSM)和双重差分模型(DID)实证分析医联体的基层医疗卫生资源配置效应及其影响因素。结果:某直辖市开展医联体试点工作区县的基层医疗卫生资源配置效率并未有效提升,即医联体政策效应不明显;政府支持力度、人力资源布局对基层医疗卫生资源配置效率存在显著的正向影响。结论:跨部门协作机制尚未建立、缺乏合理的利益分配机制、基层人才短缺的局面尚未改观等制约了医联体资源配置效应的发挥。应优化制度政策、加强部门合作、提高财政投入、加强人才培养提升医联体的政策效应。

Objective:To study the influence of the Medical Cluster on the allocation efficiency of grassroots level medical and health resources,and explain its internal action mechanism of it,so as to provide an optimal path for the"strong grassroots"of the Medical Cluster.Methods:The DEA-Malmquist index model was used to measure the allocation efficiency of grassroots level medical and health resources in a municipality,and the allocation effect of the Medical Cluster was empirically analyzed by the propensity score matching method(PSM)and the dual difference model(DID).Results:The allocation efficiency of grassroots level medical and health resources in the counties has not been effectively improved,namely,the policy effect of the Medical Cluster is not obvious;the government support and human resources distribution have a significant positive impact on the allocation efficiency of grassroots level medical and health resources.Conclusion:The cross-departmental cooperation mechanism has not been established,the lack of a reasonable profit distribution mechanism,and the situation of grassroots level talent shortage has not been changed to restrict the development of the resource allocation effect of the Medical Cluster.We should optimize the system policy,strengthen the department cooperation,increase the financial input,strengthen the talent training,and enhance the policy effect of the Medical Cluster.