中医药卫生资源配置效率时空演化及影响因素分析

Study on the Spatial and Temporal Evolution and Influencing Factors of TCM Health Resource Allocation Efficiency

目的:测算我国中医药卫生资源配置效率,分析时空演化趋势及影响因素,为优化中医医疗资源配置提供依据。方法:采用DEA-Malmquist模型分析2014-2021年我国中医药卫生资源配置效率,借助可视化工具揭示时序变化和空间差异特征,利用Tobit回归模型进一步分析中医药卫生资源配置效率的影响因素。结果:2014-2021年我国中医药卫生资源效率总体稳定但呈下降趋势,尚未实现有效配置。从空间分布来看,不同省份中医药卫生资源配置效率存在差异,中西部地区综合效率普遍高于东部地区,资源配置不均衡。结合全要素生产率及其分解结果发现,技术进步和规模效率制约了效率提高;从全要素的空间演化来看,我国各省份的全要素生产率整体呈上升趋势,大部分省份已转向效率地正增长,东西部地区整体高于中部地区,但西部地区波动幅度较大;从影响因素来看,人均可支配收入、人口密度和病床使用率对效率具有正向作用。结论:我国中医药卫生资源配置效率有待提高,且具有明显的空间分异特征,技术水平和管理体系是制约发展的主要因素。

Objective:To measure the allocation efficiency of traditional Chinese medicine(TCM)health resources in China,ana-lyze its spatial and temporal evolution trend and influencing factors,and provide a basis for optimizing the allocation of TCM medical resources.Methods:DEA-Malmquist model was used to analyze the allocation efficiency of TCM health resources in China from 2014 to 2021.The time series changes and spatial differences were revealed by visualization tools.Tobit regression model was used to fur-ther analyze the influencing factors of the allocation efficiency of TCM health resources.Results:From 2014 to 2021,the efficiency of TCM health resources in China was generally stable but showed a downward trend,and effective allocation had not yet been achieved.From the perspective of spatial distribution,there were differences in the allocation efficiency of TCM health resources in different provinces.The comprehensive efficiency of the central and western regions was generally higher than that of the eastern region,and the allocation of resources was unbalanced.Combined with total factor productivity and its decomposition results,it was found that tech-nological progress and scale efficiency restrict efficiency improvement;from the perspective of the spatial evolution of total factors,the total factor productivity of all provinces in China was on the rise as a whole,and most provinces have shifted to the positive growth of efficiency.The eastern and western regions were higher than the central region as a whole,but the western region fluctuated greatly.From the perspective of influencing factors,per capita disposable income,population density and bed utilization rate had a positive ef-fect on efficiency.Conclusion:The allocation efficiency of TCM health resources in China needs to be improved and has obvious spa-tial differentiation characteristics.Technical level and management system are the main factors restricting its development.