民族地区医疗卫生资源配置效率:空间差异、动态演进与影响因素研究

A Study of the Allocation Efficiency of the Medical and Healthcare Resources in the Ethnic Areas of China:Spatial Differences,Dynamic Evolution and Influencing Factors

基于健康中国战略背景,测算民族地区医疗卫生资源配置效率的全要素生产率,衡量民族地区医疗卫生资源配置的差异来源及演变态势。从区域差异、动态变化层面对医疗卫生配置效率进行多维分解,利用LSDVC检验影响因素。研究发现:民族地区医疗卫生资源配置效率的全要素生产率呈现逐年增长趋势,整体上表现出明显的“南高北低”空间格局;民族地区医疗卫生资源配置效率的差距主要由西南和西北区域内差异造成,区域内部的差异仍持续扩大,西北内部极化较为明显,组间差异有所削减;LSDVC-2结果显示,人口密度、人口老龄化和财政转移支付对医疗卫生资源配置水平具有显著的影响。我国民族地区医疗卫生资源配置效率整体显著提高,但配置效率赶超表现较差,区域内部差异仍旧扩大,需要重视区域发展不均衡问题,规避增长陷阱,注重区域层面医疗卫生资源结构的因地制宜,实施推动医疗卫生资源均等化的务实举措。

Against the background of the Healthy China Strategy,this paper calculates the total factor productivity(TFP)of the allocation efficiency of the medical and healthcare resources in the ethnic areas of China,and analyzes the causes of the differences and the evolutionary trends of the medical and healthcare resource allocation in these ethnic areas.It gives a multidimensional analysis of the allocation efficiency of the medical and healthcare resources at the level of regional differences and dynamic changes,and adopts LSDVC to examine the influencing factors.It has the following conclusions:the total factor productivity of the allocation efficiency of the medical and healthcare resources in these ethnic areas shows a yearly growth trend,and overall shows an obvious spatial pattern of“low in the north and high in the south”;the gap in the allocation efficiency of the medical and healthcare resources in these ethnic areas results mainly from the intra-regional differences in the southwestern and northwestern regions of China,and the differences within these regions are still expanding,with more obvious polarization within the northwestern region whose inter-group differences are on the decline.LSDVC-2 results show that population density,population aging and financial transfers have a significant impact on the level of the allocation of medical and healthcare resources.Accordingly,the paper concludes that the allocation efficiency of the medical and health resources in China’s ethnic areas as a whole has significantly improved,but its catching-up performance is fairly poor,and the intra-regional differences are still expanding.Thus,it is necessary to pay attention to solving the problems of unbalanced intra-regional development,avoid growth traps,pay attention to the structure of the medical and healthcare resources at the regional level in accordance with the local conditions,and implement the pragmatic measures to promote the equalization of medical and health resources.