基于省域视角的我国城市公立医院的全要素生产率研究

Total factor productivity of urban public hospitals in China based on provincial perspective

目的:通过对全国31个省域(不含港澳台地区)的城市公立医院医疗服务投入产出指标(2019—2021年)进行全要素生产率测算,为今后全国城市医疗卫生资源配置和规划提供依据和建议。方法:基于2019—2021年全国31个省域医疗服务投入和产出数据,采用Bootstrap-Malmquist-DEA模型,测算各省域城市公立医院的全要素生产率。结果:2019—2021年全国城市公立医院全要素生产率变化指数(TFPC)为1.083,3年间总体略有增长,呈先降后升趋势,且中部>西部>东部;2019—2020年全国TFPC为0.889,总体略有下降,且西部>中部>东部,2020—2021年全国TFPC为1.216,总体略有增长,且中部>东部>西部。结论:疫情发生后我国城市公立医院医疗服务全要素生产率先降后升,全要素生产率增长水平在各区域间不够均衡,技术进步和技术效率共同影响全要素生产率变化水平,城市公立医院在进行规模扩张的同时应更加注重自身的组织管理能力建设。

Objective:To calculate the total factor productivity(TFP)through the input-output indicators of medical services(2019-2021)of urban public hospitals in 31 provinces(excluding Hong Kong,Macao and Taiwan)in order to provide basis and suggestions for the future allocation and planning of urban medical and health resources in China.Methods:Based on the input and output data of medical services in 31 provinces from 2019 to 2021,the Bootstrap-Malmquist-DEA model was used to calculate the total factor productivity of public hospitals in cities of each province.Results:From 2019 to 2021,the change index of TFP of national urban public hospitals(TFPC)was 1.083,showing a slight increase in the three years as a whole,with a trend of first falling and then rising,and a central>western>eastern region;the national TFPC from 2019 to 2020 was 0.889,with an overall slight decrease and a western>central>eastern region.From 2020 to 2021,the national TFPC was 1.216,with an overall slight increase and a central>eastern>western region.Conclusion:After the COVID-19 outbreak,China’s urban public hospitals’TFP of medical services experiences a decline and then an increase,and the growth level of TFP is not balanced among regions.Technological progress and technological efficiency jointly affect the change level of TFP.Urban public hospitals should pay more attention to their own organizational and management capacity building while expanding their scale.