分级诊疗制度下山东省卫生服务资源配置效率评价

Evaluation on the Health Service Resources Allocation Efficiency in Shandong Province under Hierarchical Diagnosis and Treatment

目的:分析分级诊疗下山东省2012—2022年卫生服务资源配置效率的情况,为进一步改善和优化资源配置提供参考。方法:采用DEA-TOPSIS方法和DEA-Malmquist模型基于横向静态视角和纵向动态视角分析山东省卫生服务资源配置效率。结果:2022年山东省各城市的卫生服务资源配置综合技术效率、纯技术效率、规模效率的均值分别为0.887、0.945、0.939。2012—2022年山东省Malmquist指数总体波动上升,均值为0.970,Malmquist指数的下降主要受技术进步指数的影响。熵权TOPSIS排序结果表明潍坊和菏泽可作为决策者的优先考虑方案。结论:山东省卫生服务资源总量和配置效率进一步提升,但存在投入资源过剩的现象,技术进步与创新有待进一步加强。建议政府决策者优先改善目标城市的生产效率,合理调整规模、优化管理模式。

Objective:To analyze the health service resource allocation efficiency under hierarchical diagnosis and treatment in Shandong Province from 2012 to 2022,and to provide references for further improvement and optimization of health resource allocation.Methods:DEA-TOPSIS and DEA-Malmquist model were used to analyze the efficiency of health service resource allocation in Shandong Province from the horizontal static perspective and the vertical dynamic perspective.Results:The mean values of comprehensive technical efficiency,pure technical efficiency,and scale efficiency of health service resource allocation in Shandong Province in 2022 were 0.887,0.945 and 0.939 respectively.The Malmquist index of Shandong Province will generally increase with a fluctuating trend from 2012 to 2022,with an average value of 0.970.The decline of the Malmquist index was mainly influenced by the technological progress index.The entropy weighted TOPSIS ranking results indicate that Weifang and Heze could be the priority scenarios for decision makers.Conclusion:The total amount and allocation efficiency of health care resources in Shandong Province had been further improved,but there was a surplus of input resources,and technological progress and innovation needed to be further strengthened.It was recommended that government policy makers should give priority to improving the productivity of target cities,rationalizing scale and optimizing management modes.