基于三阶段DEA-Malmquist和RSR法的我国基层医疗卫生机构服务效率综合分析  

A Comprehensive Analysis of Service Efficiency in Primary Healthcare Institutions in China Based on Three-Stage DEA Malmquist and RSR Methods

作　　者：杜逸芳[1] 刘蒙 朱艳霞 刘学谦 葛国曙[1] 张怡青 Du Yifang(The First Affiliated Hospital of Soochow University,Suzhou,P.R.China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215006 [2]太仓市中医医院

出　　处：《中国卫生事业管理》2025年第1期59-62,106,共5页Chinese Health Service Management

基　　金：国家自然科学基金青年项目“基于‘淤热互结’理论探索芦黄颗粒通过FOX03-Pcsk9改善炎症微环境-胆固醇稳态抗动脉粥样硬化的机制”(82305126);南京大学中国医院改革发展研究院课题“高质量发展背景下构建基于全生命周期的继续医学教育体系的探索”(NDYG2023036)。

摘　　要：目的:以2011~2020年全国31个省(区、市)的基层医疗卫生机构的面上数据为基础,评价近10年我国基层医疗卫生机构的服务效率,分析其变化趋势,以进一步提升基层医疗卫生机构的服务效率。方法:为减少环境因素和干扰项因素的影响,运用三阶段DEA模型对2020年基层医疗卫生机构的服务效率进行静态分析,以秩和比法进行排序和分档,采用Malmquist指数对2011~2020年的数据进行动态分析。结果:三阶段DEA模型测算得出基层医疗卫生机构服务效率的综合效率、纯技术效率和规模效率分别为0.665、0.801、0.838,Malmquist指数测算得出2011~2020年我国基层医疗卫生机构的服务效率为0.837~1.153。RSR法将基层医疗卫生机构的服务效率分为四档,其中东部最高,中部次之,西部最低。结论:我国基层医疗卫生机构整体的服务效率不高,且存在地区性差异,而技术进步是限制我国基层医疗卫生机构服务效率提升的主要因素。应制定科学的基层区域卫生规划,优化基层医疗卫生资源配置,缩小地区性差异,通过提高医疗技术创新,不断推动优质医疗资源下沉。Objective To evaluate the service efficiency of primary medical and health institutions in China in the past 10 years,analyze its changing trends,and further promote its improvement.Methods A three-stage DEA model was used to conduct a static analysis of the service efficiency of primary healthcare institutions in 2020,excluding environmental and interference factors.Rank sum ratio method was used to rank and categorize the data,and the Malmquist index was used to dynamically analyze the data from 2011 to 2020.Results Based on three-stage DEA model,the overall efficiency,pure technical efficiency and scale efficiency was 0.665,0.801,and 0.838,respectively.Based on Malmquist index method,the service efficiency of primary healthcare institutions from 2011 to 2020 was 0.837~1.153,which can be divided into four grades by RSR method,in which the highest was in the eastern,next with the central,and the lowest was in the western.Conclusion The overall service efficiency of primary healthcare institutions in China was not high,and there were regional differences.Technological progress is the main factor restricting the service efficiency of primary healthcare institutions in China.China should formulate scientific grassroots regional health plans,optimize the allocation of grassroots medical and health resources,narrow the regional differences,and continuously promote the sinking of high-quality medical resources by improving medical technology innovation.

关 键 词：基层医疗卫生机构 服务效率 三阶段DEA-Malmquist RSR 

分 类 号：R197[医药卫生—卫生事业管理]