云南省卫生资源配置公平性及效率分析

Equity and efficiency of health resource allocation in Yunnan province

目的描述当前云南省卫生资源配置状况,评价其公平性及利用效率,并为卫生资源的优化配置提供建议。方法运用洛伦兹曲线、基尼系数、卫生资源集聚度评价卫生资源配置的公平性,运用三阶段DEA模型、Malmquist指数模型评价利用效率。结果2017年—2022年云南省各类卫生资源总量持续增加,卫生资源按照人口、经济配置的公平性较好,按地理配置不平衡;在剔除环境变量和随机干扰的影响后,2022年云南省卫生资源配置综合技术效率均值为0.971,5个市(州)资源利用非DEA有效;2017年—2022年13个市(州)全要素生产率小于1,主要受技术进步变动的影响。结论建议充分考量各市(州)人口、经济、地理等因素,科学配置资源,加快薄弱地区的技术创新和区域协同,逐步缩小地区间差异,提升云南省卫生资源利用效率以满足居民多样化就医需求。

Objective To delineate the distribution of health resources in Yunnan province,assess the equity and efficiency of resource allocation and utilization,and offer recommendations on optimizing health resource allocation.Methods The equity of health resource allocation was gauged using the Lorentz curve,Gini coefficient,and health resources agglomeration degree,and the utilization efficiency was assessed using the three-stage data envelopment analysis(DEA)model and Malmquist index.Results The total amount of various health resources in Yunnan province continued to increase from 2017 to 2022.Health resources were fairly allocated according to population and economy but showed imbalance geographically.After the environmental variables and random interference were ruled out,the average comprehensive technical efficiency of medical and health resource allocation in Yunnan province was 0.971 in 2022,and the utilization of resources in 5 cities/prefectures was not DEA efficient.From 2017 to 2022,the total factor productivity was below 1 in the 13 cities/prefectures,mainly due to technological advances.Conclusion Health resources should be rationally allocated according to population,economy,and geography in different cities/prefectures in Yunnan province,which will help to strengthen technological innovations and regional collaboration in weak areas and gradually narrow the regional gaps,thus raising the efficiency of health resource utilization and meeting the diverse medical needs of residents.