基于公平与效率的我国乡镇卫生院卫生资源配置研究

Researches on the Allocation of Health Resources in Township Health Centers in China Based on Equity and Efficiency

目的:分析评价2009~2021年我国乡镇卫生院卫生资源配置的公平与效率,为优化乡镇卫生院卫生资源配置提供参考。方法:运用集聚度评价我国乡镇卫生院卫生资源配置公平性,运用数据包络分析方法分析我国乡镇卫生院卫生资源配置效率。结果:2009~2021年,我国东部地区乡镇卫生院卫生资源按地理面积配置公平性较好但按人口数配置的公平性较差;中部地区乡镇卫生院卫生资源集聚度接近于1,按人口数配置的公平性也较好;西部地区乡镇卫生院卫生资源集聚度均小于1,但按人口数配置的公平性较好。2021年我国乡镇卫生院卫生资源配置的综合技术效率、纯技术效率和规模效率均值分别为0.431、1.000和0.431。结论:我国乡镇卫生院卫生资源配置的地区差异较大,东部地区的人口可及性较差,西部地区的地理可及性较差,应因地制宜优化资源配置。我国乡镇卫生院卫生资源配置效率不高,在适当控制投入的同时应该提高资源利用效率。

Objective To analyze and evaluate the fairness and efficiency of health resources allocation in township health centers in China from 2009 to 2021,and provide reference for optimizing the allocation of health resources in township health centers.Methods Cluster degree was used to evaluate the fairness of health resource allocation in township health centers in China,and data envelopment analysis was used to analyze the efficiency of health resource allocation in township health centers in China.Results From 2009 to 2021,according to geographical area,the fairness of health resources allocation in township health centers was good in eastern China,but it was poor according to the population.The concentration degree of health resources in township health centers in the central region was close to 1,and the fairness of allocation based on population size was also good.In the western region,the concentration degree of health resources in township health centers was less than 1,but the fairness of allocation based on population size was better.In 2021,the average comprehensive technical efficiency,pure technical efficiency and scale efficiency of health resource allocation in township health centers in China was 0.431,1.000 and 0.431,respectively.Conclusion There are significantly regional dfferences in the allocation of health resources in township health centers in China,with poor population accessibility in the eastern region and geographical accessibility in the western region.The allocation of resources should be optimized according to local conditions.The allocation efficiency of health resources in township health centers in China was not high.It is necessary to improve the resource utilization efficiency while properly controlling investment.