长江三角洲区域卫生资源配置公平性与效率研究

Research on the Equity and Efficiency of Health Resource Allocation in the Yangtze River Delta Region

目的:评估2021年长江三角洲区域卫生资源配置的公平性及效率,为促进长三角区域卫生事业发展的高质量及一体化提供参考。方法:利用基尼系数和泰尔指数评价公平性,利用三阶段DEA模型评价效率。结果:在公平性方面,按人口配置的卫生资源基尼系数介于0.04-0.38,3省份按地理配置的基尼系数介于0.19-0.32,上海市介于0.47-0.70。泰尔指数显示3省份卫生资源配置主要体现为组内差异,上海市主要体现为组间差异。在效率方面,剔除环境因素及随机误差的干扰后,长三角区域平均综合效率、纯技术效率、规模效率分别为0.939、0.994、0.944,江苏省、浙江省达到了DEA有效,上海市分别为0.817、1.000、0.817,安徽省分别为0.937、0.977、0.959。结论:长三角区域卫生资源按人口配置均处于公平状态。按地理配置的公平性差于人口配置,其中上海市的地理配置处于不公平状态。长三角区域卫生资源配置效率总体较高,存在区域间差异。

Objective:To evaluate the equity and efficiency of health resource allocation in the Yangtze River Delta region in 2021,so as to provide references for achieving high quality and integration of health development in the Yangtze River Delta region.Methods:Gini coefficient and Thiel index were used to evaluate the equity.The three-stage DEA model was used to evaluate the efficiency.Results:In terms of equity,the Gini coefficient of health resources allocated by population ranged from 0.04-0.38.The Gini coefficient allocated by geography ranged from 0.19-0.32 in the three provinces,and was between 0.47-0.70 in Shanghai.The Thiel index showed that the allocation of health resources was mainly based on intra-group differences in the three provinces,and it was mainly based on inter-group differences in Shanghai.In terms of efficiency,after excluding the interference of environmental factors and random errors,the average comprehensive efficiency,pure technical efficiency and scale efficiency in the Yangtze River Delta region were 0.939,0.994 and 0.944,respectively.Jiangsu and Zhejiang reached the DEA effectiveness.The efficiency of Shanghai was 0.817,1.000 and 0.817 respectively,and the efficiency of Anhui was 0.937,0.977 and 0.959 respectively.Conclusion:The allocation of health resources in the Yangtze River Delta region is in a fair state according to population.The equity of geographical allocation is worse than that of population allocation,and the geographical allocation of Shanghai is in an unfair state.The efficiency of health resource in the Yangtze River Delta region is generally high,and there are regional differences.