资源错配对医疗服务绩效的影响研究——基于我国省级动态面板数据的GMM分析  

Researches on the Impact of Misallocation of Medical Resources on the Performance of Health Care Services Based on GMM Analysis of Provincial Dynamic Panel Data.

作　　者：张开翼 符佳玮 舒燕 Zhang Kaiyi(School of Public Health and Management,Guangzhou University of Chinese Medicine,Guangzhou,P.R.China.)

机构地区：[1]广州中医药大学公共卫生与管理学院,广东广州510006

出　　处：《中国卫生事业管理》2023年第7期526-530,560,共6页Chinese Health Service Management

基　　金：2021年度教育部人文社会科学研究规划基金“中国健康服务生产效率的空间特征和优化体系研究——基于健康地理学视角”(21YJAZH074);广州市哲学社科规划2021年度课题“粤港澳大湾区健康服务生产效率的区域差异和提升策略研究”(2021GZGJ15);2022年广东省哲学社科规划课题“基于协同发展理论的粤港澳大湾区公共服务供给效率评估和提升路径研究”(GD22XGL51);2022年广东省教育科学规划课题“粤港澳大湾区中医药健康服务业协同发展评价和优化路径研究——基于高质量发展背景”(2022GXJK061);广州中医药大学2020年度人文社科项目重点专项“基于创新驱动的我国医疗服务业开放路径研究”(2020SKZD07)。

摘　　要：目的:测算我国医疗服务绩效,考察资源错配对医疗服务绩效的影响效应,探索提升医疗服务绩效的具体路径。方法:基于2012~2019年我国31个省(市、自治区)的面板数据,将医疗服务质量作为产出指标之一,运用超效率SBM模型测算我国医疗服务绩效;运用最小二乘虚拟变量模型LSDV测算医疗资源错配;分别构建静态和动态面板GMM模型,检验医疗资源错配对医疗服务绩效的影响。结果:我国医疗服务绩效存在显著的区域差异,样本地区均存在医疗资源错配现象。GMM模型结果显示,医疗资源错配对医疗服务绩效有显著的负向影响,滞后一期的医疗服务绩效对当期医疗服务绩效具有显著的促进作用;人均GDP、医疗市场的竞争程度、人口密度均能显著提高医疗服务绩效;政府干预具有显著的阻碍作用。结论:从鼓励医疗行业的要素流动、推进医疗市场化改革、加强政府的宏观调控能力等方面提升医疗服务绩效。Objective To measure the performance of health care services in China,investigate the impact of medical misallo-cation on health care service performance,and explore the specific ways to improve the performance of health care services.Meth-ods Based on the panel data of 31 provinces(cities,autonomous regions)in China from 2012 to 2019,the quality of health care services was taken as one of the output indicators,the SBM model was used to measure the performance.The medical misallocation was measured by the least squares dummy variable model LSDV,and the influence of which on the performance of health care serv-ices was tested by developing static and dynamic panel GMM models.Results There were significant regional differences in the per-formance of health care services,and the same was true for medical misallocation.The GMM model showed that medical misalloca-tion had a significantly negative impact on the performance of health care services,and the performance with a lag of one period had a significantly promoting effect on the current performance.Per capita CDP,the degree of competition in medical market and popu-lation density could significantly improve the performance,but the government intervention could significantly hinder the performance.Conclusion It was suggested to encourage the flow of factors in health care services,promote the reform of medical marketiza-tion,and strengthen the government's macro-control ability.

关 键 词：医疗服务绩效 医疗资源错配 影响因素 动态面板数据 广义矩分析 

分 类 号：R197.1[医药卫生—卫生事业管理]