县域医共体建设下的我国乡镇卫生院医疗资源配置效率分析  

Analysis of Medical Resources Allocation Efficiency of Township Health Centers Under the Construction of County Medical Community

作　　者：徐欣 高红霞[1,2] 王栋 陈迎春 XU Xin(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]湖北省高校人文社科重点研究基地——农村健康服务研究中心,湖北武汉430030

出　　处：《医学与社会》2023年第5期20-25,共6页Medicine and Society

基　　金：教育部人文社会科学基金资助项目,编号为21YJA630017。

摘　　要：目的:分析县域医共体建设下的乡镇卫生院医疗资源配置效率的变化,为提高乡镇卫生院医疗资源配置效率提供参考。方法:基于K-means聚类筛选2016年乡镇卫生院资源投入与产出情况相近的6个样本省份,梳理医共体政策对乡镇卫生院医疗资源配置效率的影响,使用BCC模型和Malmquist指数分析法进行静态与动态效率分析。结果:政策分析发现,县域医共体下涵盖基层能力建设、薪酬制度、医保支付制度、医保补偿政策、信息化5个维度会对乡镇卫生院效率产生影响;2016-2020年县域医共体建设以来,样本省份乡镇卫生院医疗资源配置平均全要素生产率均大于1;至2020年安徽从非DEA有效变为DEA有效;浙江、陕西保持DEA有效;江苏、湖北、贵州为非DEA有效。结论:县域医共体政策可以促进乡镇卫生院医疗资源配置效率改善,但是改善幅度需结合地区经济状况和资源禀赋;乡镇卫生院存在产出速度低于投入速度的问题;技术进步是当前乡镇卫生院医疗资源配置效率增长的主要推动力,但无法长远推动,需注重技术效率和技术进步共同发展。Objective:To analyze the changes of allocation efficiency of medical resources in township hospitals under the county medical community,so as to provide references for improving the allocation efficiency of medical resources in township hospitals.Methods:Based on K-means clustering,6 sample provinces with similar resource input and output of township health centers in 2016 were screened.Based on the medical community policy of the sample provinces,the logic of its impact on the allocation efficiency of medical resources in township health centers was sorted out.Static and dynamic efficiency analyses were performed using the BCC model and Malmquist index analysis.Results:The policy analysis found that the county medical community influenced the efficiency of township health centers through five dimensions:grassroots capacity building,remuneration system,health insurance payment system,health insurance compensation policy and information technology.The data results showed that since 2016-2020,the average total factor productivity of medical resource allocation in township health centers in the sample provinces had been greater than 1.By 2020,Anhui had been changed from non-DEA effectiveness to DEA effectiveness.Zhejiang and Shaanxi had been kept DEA effective.Jiangsu,Hubei,and Guizhou had been kept non-DEA effective.Conclusion:The county medical community policy can promote the improvement of medical resources allocation efficiency in rural health centers,but the magnitude of improvement needs to be combined with regional economic conditions and resource endowment.The township health center has a problem of output at a slower rate than input.Technological progress is the main driving force behind the increase in the efficiency of the allocation of medical resources in township health centers,but it cannot be promoted in the long run and needs to focus on the joint development of technical efficiency and technological progress.

关 键 词：医疗资源 配置 效率 县域医共体 乡镇卫生院 

分 类 号：R197[医药卫生—卫生事业管理]