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长江三角洲地区政府卫生支出效率评价及影响因素研究

Evaluation and Influencing Factors of Government Health Expenditure Efficiency in the Yangtze River Delta Region
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摘要 目的:对长三角地区政府卫生支出的效率进行评价,并分析其影响因素,为促进长三角地区卫生健康一体化的进程提供参考。方法:运用熵值法测算各市的政府卫生支出效率并分析其空间演化特征,采用空间相关分析和空间计量经济模型检验其空间相关性并分析其影响因素。结果:2012-2021年长三角地区政府卫生支出效率的均值为0.251,效率较低但整体呈上升态势。各地政府卫生支出效率差异显著,呈现“南高北低,东高西低”的空间分布格局以及南北差距逐渐拉大的空间演化特征。长三角地区政府卫生支出效率的全局莫兰指数系数为正(P<0.001),具有显著的正向空间相关性。财政收入分权对政府卫生支出效率存在负向影响,总效应系数为-4.008。而财政支出分权和财政自给率表现出相反的结果,总效应系数分别为5.504、3.568。结论:长三角地区政府卫生支出效率仍有较大提升空间,缩小地区差距并注重空间效应是长三角地区卫生健康一体化的关键。建议推进区域医疗资源共享,发挥地方政府的标杆效应,完善财政分权体制,促进政府卫生支出效率的整体提升。 Objective:To evaluate and analyze the efficiency and influencing factors of government health expenditure in the Yangtze River Delta region,so as to provide a reference for promoting the process of health integration in the Yangtze River Delta region.Methods:The study employed the entropy method to measure the efficiency of government health expenditure in each city and analyzed its spatial heterogeneity and spatial evolution characteristics.Spatial correlation analysis and spatial econometric model were used to test its spatial correlation and analyze its influencing factors.Results:The average efficiency of government health expenditure in the Yangtze River Delta region from 2012 to 2021 was 0.251,which was less effective but on the rise overall.There were notable variations in the efficiency of government health expenditure between different regions,showing a spatial distribution pattern of"high in the south and low in the north,high in the east and low in the west",and a spatial evolution characteristic of the gradual widening of the gap between the north and the south.The global Moran's I coefficient for the efficiency of government health expenditure in the Yangtze River Delta region was positive(P<0.001),indicating a significant positive spatial correlation.Fiscal revenue decentralization had a negative impact on the efficiency of government health expenditure,with a total effect coefficient of-4.008.In contrast,fiscal expenditure decentralization and fiscal self-sufficiency rate showed opposite results,with total effect coefficients of 5.504 and 3.568,respectively.Conclusion:There is still considerable room for improvement in the efficiency of government health expenditure in the Yangtze River Delta region.Narrowing regional disparities and emphasizing spatial effects are crucial to the integration of healthcare in the Yangtze River Delta region.It is recommended to promote the sharing of regional medical resources,leverage the bench-marking effect of local governments,and improve the fiscal decentralization system to enhance the overall efficiency of government health expenditure.
作者 姜城蕾 宋国强 邱林萍 刘梦 孙先红 严静 赵林海 JIANG Chenglei(School of Health Management,Anhui Medical University,Hefei,Anhui,230032,China)
出处 《医学与社会》 北大核心 2024年第12期32-38,共7页 Medicine and Society
基金 国家社会科学基金资助项目,编号为19CGL062 安徽省高校科学研究重大项目,编号为2023AH040074 安徽医科大学医院管理研究所项目,编号为2023gykj10。
关键词 政府卫生支出 效率 影响因素 长三角地区 Government Health Expenditure Efficiency Influencing Factor Yangtze River Delta Region
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