我国基层医疗卫生资源配置效率及影响因素研究  

Study on allocative efficiency of primary medical and health resources and influencing factors in China

作　　者：刘晖[1] 王乐乐 寇丽圆 夏小川 董强玲 何欣悦 LIU Hui;WANG Lele;KOU Liyuan;XIA Xiaochuan;DONG Qiangling;HE Xinyue(School of Health Management,Gansu University of Chinese Medicine,Lanzhou Gansu 730000,China;School of Public Health,Gansu University of Chinese Medicine,Lanzhou Gansu 730000,China)

机构地区：[1]甘肃中医药大学卫生管理学院,甘肃兰州730000 [2]甘肃中医药大学公共卫生学院,甘肃兰州730000

出　　处：《卫生软科学》2024年第8期53-57,共5页Soft Science of Health

基　　金：甘肃省教育厅2023年高校教师创新基金项目(2023A-089);甘肃省科技厅2023年软科学专项(23JRZA462)。

摘　　要：[目的]通过研究我国基层医疗卫生资源配置效率及其影响因素,为提高我国基层医疗卫生资源配置效率提供参考。[方法]选择基层医疗卫生机构中的机构人员数、床位数、机构数为投入指标,诊疗人次数、入院人次数为产出指标,农村居民人均可支配收入、城镇化率、执业(助理)医生数、地区生产总值为环境指标,利用三阶段DEA-Tobit模型对我国基层医疗卫生2012-2021年的数据进行静态分析和回归分析。[结果]农村居民人均可支配收入、城镇化率、执业(助理)医生数、地区生产总值对我国基层医疗卫生资源影响显著;在剔除环境变量和随机干扰的影响后,我国基层医疗卫生资源综合效率、纯技术效率、规模效率的均值降幅分别为8.5%、1.8%、8.7%,资源投入和产出不相匹配;SFA回归分析显示,执业(助理)医生数是影响综合效率值的显著因素。[结论]各地区基层医疗机构卫生资源配置存在明显差异,人才短缺和经济发展水平制约了基层医疗卫生资源配置效率。政府应通过宏观调控加大对基层、边远地区和紧缺医学专业人才的培养扶持力度,缩减城乡、地区、专业之间人才资源配置差距。Objective This paper studies the allocative efficiency of primary medical and health resources and influencing factors in China to provide the reference for improving the allocative efficiency of primary medical and health resource in China.Methods The number of personnel,the number of beds and the number of institutions in primary medical and health institutions were selected as input indicators.The number of patients diagnosed and treated and the number of hospital admission were selected as output indicators.The per capita disposable income of rural residents,urbanization rate,the number of practicing(assistant)doctors and gross regional product were environmental indicators.The data of primary health care in China from 2012 to 2021 were analyzed by static analysis and regression analysis by three-stage DEA-Tobit model.Results Per capita disposable income of rural residents,urbanization rate,the number of practicing(assistant)doctors and gross regional product had a significant impact on the primary medical and health resources in China.After eliminating the influence of environmental variables and random interference,the average decline of comprehensive efficiency,pure technical efficiency and scale efficiency of primary medical and health resources in China was 8.5%,1.8%and 8.7%,respectively,indicating that resource inputs and outputs did not match.SFA regression analysis showed that the number of practicing(assistant)doctors was a significant factor affecting the value of comprehensive efficiency.Conclusions There are obvious differences in the allocation of health resources of primary medical and health institutions in different regions,and the shortage of talents and the level of economic development restrict the allocative efficiency of primary medical and health resources.The government should strengthen the training and support for medical professionals in grassroots,remote areas and in short supply through macro-control to narrow the gap of human resources allocation among urban and rural areas,region

关 键 词：三阶段DEA模型 TOBIT模型 基层医疗卫生资源 配置效率 影响因素 

分 类 号：R197[医药卫生—卫生事业管理]