基于DEA‐Malmquist模型的粤港澳大湾区医疗服务产出效率研究

Research on output efficiency of medical services in Guangdong‐HongKong‐Macao Greater Bay Area based on DEA and Malmquist index

目的分析粤港澳大湾区医疗服务产出效率,为区域卫生健康事业高质量发展提供参考建议。方法收集2015—2020年粤港澳大湾区医疗卫生资源与服务面板数据,用数据包络分析(data envelopment analy‐sis,DEA)的BCC模型分析各评价单元的医疗服务效率,用Malmquist指数模型进行纵向比较。结果2015—2020年粤港澳大湾区执业(助理)医师、注册护士、床位数,年均分别增长6.9%、6.9%、4.2%,总诊疗人次、出院人次持续增长后在2020年首次出现回落。2020年,佛山等5个评价单元DEA有效,珠海等3个评价单元DEA无效,DEA无效单元均存在产出不足或投入冗余。分年度看,全要素生产率变化指数2018—2019年度大于1,其余年间均小于1;分地区看,11个评价单元全要素生产率变化指数均小于1。结论粤港澳大湾区医疗卫生资源逐年稳步增长,医疗服务量在长期增长基础上首次出现回落。粤港澳大湾区内部评价单元之间运行效率存在差异。技术变化是制约全要素生产率提高的瓶颈。需进一步加强区域联动,促进区域整体医疗服务效率的提升。

Objective To analyze the output efficiency of medical services in the Guangdong‐Hong Kong‐Macao Greater Bay Area,and provide reference suggestions for the high‐quality development of regional health development.Methods Collecting the panel data of health resources and services in Guangdong‐Hong Kong‐Macao Greater Bay Area from 2015 to 2020,the BCC model of data envelopment analysis(DEA)was used to analyze the medical service efficiency of each evaluation unit and the Malmquist index was used to make a vertical comparison.Results From 2015 to 2020,the number of licensed(assistant)doctors,registered nurses,and beds in the Guangdong‐Hong Kong‐Macao Greater Bay Area increased by 6.9%,6.9%,and 4.2%annually,the total number of visits and discharge patients declined for the first time in 2020 after years of continuous growth.In 2020,five regions including Foshan showed DEA efficiency,three regions includ‐ing Zhuhai showed DEA invalid,all the DEA invalid units had insufficient output or redundant input.From the perspective of year,the total factor productivity change index(TFP)was greater than 1 in 2018-2019,and less than 1 in other years.From the perspective of regions,TFP of 11 evaluation units were less than 1.Conclusions The medical and health resourc‐es in the Guangdong‐Hong Kong‐Macao Greater Bay Area have steadily increased year by year,and the quantity of medical services dropped for the first time on the basis of long‐term growth.There were differences in service efficiency between the internal evaluation units of Guangdong‐Hong Kong‐Macao Greater Bay Area.Technological change was the bottleneck re‐stricting the improvement of total factor productivity.Regional linkage needs to be strengthened to further improve the efficiency of medical services.