基于数据包络分析的我国基层医疗卫生机构配置效率研究  

Research on the allocation efficiency of primary medical and health institutions in China based on data envelopment analysis

作　　者：郑楠暄 吴琳艳 吴胤歆[1] 马龙 甘雯菲 姬晶晶 Zheng Nanxuan;Wu Linyan;Wu Yinxin;Ma Long;Gan Wenfei;Ji Jingjing(School of Health Management,Fujian Medical University,Fuzhou 350122,China;School of Public Health,Fujian Medical University,Fuzhou 350122,China)

机构地区：[1]福建医科大学卫生管理学院,福州350122 [2]福建医科大学公共卫生学院,福州350122

出　　处：《中华医院管理杂志》2023年第3期223-229,共7页Chinese Journal of Hospital Administration

基　　金：福建省科技厅创新战略研究项目(2022R0036)。

摘　　要：目的:分析我国各地基层医疗卫生机构卫生资源的投入产出状况及其配置效率,为优化我国基层医疗卫生资源在地区间的配置提供实证依据。方法:从《2021中国卫生健康统计年鉴》中提取2020年我国基层医疗卫生机构的投入指标数据(床位数、人员数)和产出指标数据(诊疗人次数、家庭卫生服务人次数、入院人数),基于数据包络分析(DEA)的BCC(Banker, Charnes, Cooper)模型,利用Bootstrap-DEA方法纠偏,测算我国31个省(自治区、直辖市)基层医疗卫生资源的配置效率,并分析地区差异。结果:纠偏后基层医疗卫生机构资源配置综合技术效率值下降了0.102。我国基层医疗卫生机构综合技术效率平均值为0.669,存在较严重的技术无效使用。东、中、西部地区的综合技术效率值分别为0.694、0.663、0.649,中部地区内部两极分化明显。对非DEA有效省份的效率改进进一步分析发现,2个DEA弱有效省份和16个DEA无效省份有若干个效率配置改进的参考省份;被参考频次超过10次的省份分别为浙江、重庆、四川、宁夏,而被其他省份列为第一参考的省份为宁夏、重庆、浙江和西藏。结论:我国基层医疗卫生机构资源配置效率相对较低,且地区差异明显。对基层医疗卫生机构进行资源配置时需考虑不同投入、不同产出之间的平衡。非DEA有效省份可以通过DEA分析,寻找最合适的参考对象,在短期内进行参考改进。ObjectiveTo analyze the input and output status of health resources in primary medical and health institutions and their allocation efficiency in different regions of China,and to provide an empirical basis for optimizing the allocation of primary medical and health resources in China among regions.MethodsThe input index data(number of beds and number of health personnel)and output index data(number of primary medical and health institutions visits,number of family health services,number of hospital admissions)of primary medical and health institutions in China in 2020 were extracted from the China Health Statistical Yearbook 2021.Based on the BCC(Banker,Charnes,Cooper)model of data envelopment analysis(DEA),the Bootstrap-DEA method was used to correct bias,the allocation efficiency of primary medical and health resources in 31 provinces was calculated and the regional differences were analyzed.ResultsAfter bias correction,the technical efficiency(TE)of resource allocation in primary medical and health institutions decreased by 0.102.The average TE score of all 31 primary medical and health institutions was 0.669,indicating a serious problem of ineffective use of technology.The TE of the eastern,central and western regions was 0.694,0.663,and 0.649 respectively.There was obvious polarization in the central regions.Further analysis of the efficiency improvement of non DEA efficient provinces showed that 2 DEA weakly efficient provinces and 16 DEA ineffective provinces had several reference provinces for efficiency configuration improvement;The provinces that have been referenced more than 10 times were Zhejiang,Chongqing,Sichuan,and Ningxia,while the provinces that were listed as the first reference by other provinces were Ningxia,Chongqing,Zhejiang,and Tibet.ConclusionsThe resource allocation efficiency of primary medical and health institutions in China is relatively low,and regional differences are obvious.The balance between different inputs and outputs should be considered when allocating the resources.Non DE

关 键 词：卫生资源 基层医疗卫生机构 数据包络分析 资源配置 配置效率 

分 类 号：R197[医药卫生—卫生事业管理]