2017-2021年我国基层卫生资源配置的公平与效率研究

Equity and efficiency of primary health resource allocation in China,2017—2021

目的分析我国2017—2021年基层卫生机构资源配置公平与效率的现状,为我国基层医疗资源优化配置提供参考依据。方法基于已有文献构建投入与产出评价指标,运用基尼系数与DEA-Malmquist指数模型对我国医疗卫生资源配置公平性与效率水平进行测度。结果我国2017—2021年全国基层卫生资源配置按人口分布达到高度公平,但卫生机构床位数量公平性逐年降低。“十三五”期间我国卫生资源配置Malmquist指数均值为0971,表明我国各地区基层卫生资源配置效率整体呈现下降趋势,其中技术效率指数在2019年之后下降幅度较为明显。全国31个省市中仅江苏省及贵州省卫生资源配置效率指数大于1,从区域角度看西南地区整体卫生资源配置效率进步较显著。结论我国基层卫生资源配置的公平性总体较好,但整体配置效率不理想,技术创新能力逐年下降。因此,基层卫生院卫生资源的配置需要在坚持公平的基础上提升效能,促进低效率地区的技术创新和区域协同,合理调控规划,提升基层卫生服务的可及性和竞争力,提高基层卫生服务效率。

Objective To analyze the current situation of equity and efficiency of resource allocation in pri⁃mary health institutions in China from 2017 to 2021,and to provide reference for the optimal allocation of primary health resources in China.Methods Based on the existing literature,input and output evaluation indexes were constructed,and the Gini coefficient and DEA⁃Malmquist index model were used to measure the fairness and effi⁃ciency of medical and health resource allocation in China.Results From 2017 to 2021,the allocation of primary health resources in China reached a high degree of fairness according to population distribution,but the fairness of the number of beds in health institutions decreased year by year.During the“Thirteenth Five⁃Year Plan”period,the average Malmquist index of health resource allocation in China was 0971,indicating that the overall efficiency of primary health resource allocation in various regions of China showed a downward trend.Among them,the tech⁃nical efficiency index fell significantly after 2019.Among the 31 provinces and cities in China,only Jiangsu Prov⁃ince and Guizhou Province had a health resource allocation efficiency index greater than 1,and from the regional perspective,the overall health resource allocation efficiency in southwest China improved significantly.Conclu⁃sions The fairness of the allocation of primary health resources in China is generally good,but the overall alloca⁃tion efficiency is not ideal,and the technological innovation ability is declining year by year.Therefore,it is nec⁃essary to improve the allocation efficiency of health resources in primary health centers on the basis of fairness,promote technological innovation and regional coordination in inefficient areas,rationally regulate and plan health resource allocation,improve the accessibility and competitiveness of primary health services,and improve the effi⁃ciency of primary health services.