我国政府卫生支出效率评价与提升路径研究

Evaluation and improvement path of the health expenditure efficiency of Chinese government

目的比较分析我国政府卫生支出效率,并对其提升路径进行研究。方法利用两阶段DEA模型,将政府卫生支出划分为医疗卫生资源改善和社会经济产出两阶段,分析我国31个省份的政府卫生支出总效率及两阶段效率,并使用模糊集定性比较分析方法分析现阶段政府卫生支出高效率的路径组态。结果效率评价结果显示,我国政府卫生支出总效率为0.820,医疗卫生资源改善阶段效率为0.812,社会经济产出阶段效率为0.845;定性比较分析结果得出3种政府卫生支出配置高效率的路径,分别为政府主导型路径、高教育主导型路径、市场经济驱动型路径。结论我国政府卫生支出效率水平不高,且不同地区效率存在较大差异。应改善政府卫生支出各阶段效率,提升政府卫生支出总效率。应发挥地方政府在政府卫生支出配置效率的引领作用,并根据不同省份的情况,有针对性地采用不同路径,差异化地提升我国政府卫生支出配置效率。

Objective To compare and analyze the efficiency of health expenditure of the Chinese government and to explore the configuration path to improve the efficiency of health resource allocation in the country.Methods Using a two-stage data envelopment analysis(DEA)model,we divided the government health expenditure into two stages:medical and health resource improvement and socio-economic output.The overall efficiency and two-stage efficiencies of government health expenditure in 31 provinces across China were analyzed.In addition,the fuzzy set qualitative comparative analysis(fsQCA)was used to analyze the current path to achieving high efficiency of government health expenditure.Results The efficiency assessment revealed that the overall health efficiency of the Chinese government was 0.820,the efficiency in the medical and health resource improvement stage was 0.812,the efficiency of the socio-economic output stage was 0.845.fsQCA showed that there are three paths towards achieving high efficiency in the allocation of government health resources,namely the government-led path,the high-education-led path,and the market-driven path.Conclusions The efficiency of health expenditure of the Chinese government is not high and differs greatly among different regions.The efficiency of government spending on healthcare needs improvement at every stage to ensure an overall increase in efficiency.Local governments should take the lead in efficiently allocating government health expenditures.To improve the efficiency of such spending,targeted approaches should be adopted based on the unique needs of each province.