管理评论

管理评论 ›› 2022, Vol. 34 ›› Issue (12): 312-321.

• 公共管理 • 上一篇    下一篇

基于三阶段DEA的我国医疗卫生服务体系效率测度研究

于本海1, 汪婷1, 何闯1, 郑丽伟2, 郭首玮1   

  1. 1. 上海应用技术大学经济与管理学院, 上海 200235;
    2. 上海应用技术大学计算机科学与信息工程学院, 上海 201418
  • 收稿日期:2020-09-21 出版日期:2022-12-28 发布日期:2023-01-16
  • 作者简介:于本海,上海应用技术大学经济与管理学院教授,博士生导师,博士;汪婷,上海应用技术大学经济与管理学院硕士研究生;何闯,上海应用技术大学经济与管理学院硕士研究生;郑丽伟,上海应用技术大学计算机科学与信息工程学院副教授,硕士;郭首玮,上海应用技术大学经济与管理学院讲师,博士。
  • 基金资助:
    国家自然科学基金项目(71974131);教育部人文社会科学研究青年基金项目(18YJC630196);国家社会科学基金项目(20BSH151)。

Research on the Efficiency of China Health Service System Based on Three-stage DEA

Yu Benhai1, Wang Ting1, He Chuang1, Zheng Liwei2, Guo Shouwei1   

  1. 1. School of Economics and Management, Shanghai Institute of Technology, Shanghai 200235;
    2. School of Computer Science & Information Engineering, Shanghai Institute of Technology, Shanghai 201418
  • Received:2020-09-21 Online:2022-12-28 Published:2023-01-16

PDF (PC)

215

摘要： 医疗卫生服务体系建设是各级政府和广大民众关注的热点问题之一。本文以基层医疗卫生机构、医院、专业公共卫生机构为研究对象,以医疗卫生服务体系中的人力及资本为投入指标,从医疗机构的主要服务项目成果中选取产出指标,从宏观经济、社会环境和政策支持三方面选择人均GDP、人口密度及政府卫生支出为环境变量,采用三阶段DEA模型测算2010—2017年我国医疗卫生服务体系效率。实证结果表明:不考虑外部环境和随机干扰,我国医疗卫生服务体系效率整体偏高;SFA回归分析表明外部环境和随机干扰是影响我国医疗卫生服务体系效率的重要因素,人均GDP及人口密度的增加对医疗卫生服务体系效率的提升影响不大,而政府卫生支出的增加可以推动医疗卫生服务体系效率的提升;剔除环境及随机干扰等因素的影响后,我国医疗卫生服务体系综合效率均值为0.802,多处于规模递增状态;东部地区综合效率下降幅度较大的省份为北京、天津、海南;中部地区为吉林,西部地区为西藏、宁夏和青海;但是在整体上东部地区的综合效率最高,西部地区最低。研究进一步表明,合理配置医疗资源,促进优质医疗资源向基层下移,提高基层医疗机构的医技水平,有助提升区域医疗卫生服务体系整体效率水平。

关键词: 医疗卫生服务体系, 运行效率, 三阶段DEA模型

Abstract: The construction of health services is a hot issue that governments and the general public are concerned about. This paper takes primary medical and health care institution, hospitals and professional public health institutions as the research object; takes human and capital as the input index in the health service system; selects the output index from the main service items of the medical institutions; selects the per capita GDP, population density and government health expenditure as the environmental variables from three aspects: macroeconomy, social environment and policy support; and uses the three-stage DEA model to calculate the efficiency of health service system from 2010 to 2017. The empirical results show that: the efficiency of health service system is on the high side without considering the influence of environment and random interference. SFA regression analysis shows that external environment and random interference are important factors affecting the efficiency of health service system. The increase of per capita GDP and population density has little effect on the efficiency of health service system. Increased government health spending can drive efficiency improvements in health service system. After excluding the influence of factors, the average comprehensive efficiency of health medical service system is 0.802, mostly in a state of increasing scale. The largest decline in comprehensive efficiency occurs in Beijing, Tianjin and Hainan in the east region, Jilin in the central region, and Tibet, Ningxia and Qinghai in the west region. However, the overall efficiency is the highest in the east region and the lowest in the west region. The research further shows that the rational allocation of medical resources, the promotion of high-quality medical resources to the grass-roots level, and the improvement of the medical technology level of primary medical institutions will help to improve the overall efficiency of the regional health service system.

Key words: health service system, operational efficiency, three-stage DEA model