摘要
[目的]测算广东省各区域间的基层医疗机构公平性和效率,为提高基层医疗卫生机构运行效率提供基础资料和参考。[方法]运用泰尔指数对广东省各区域间基层卫生资源配置的公平性进行分析;运用DEA的BCC-CCR模型和Malmquist模型对广东省各区域进行横纵向分析。[结果]2014-2019年,广东省21个市的基层卫生机构DEA有效城市占28.6%,规模效率是综合效率的主要影响因素;全要素生产率平均变化为-3.1%,导致全要素生产率低的原因主要是技术进步增长缓慢。[结论]广东省基层卫生资源区域性差异明显,床位配置不合理,珠三角地区优质资源扎堆且存在内部分配不均的情况;在公平性方面,广东省各区域间基层医疗卫生资源配置公平性偏低;在效率方面,三级医院的辐射作用带动基层卫生资源综合效率的提高,综合效率的有效性与技术效率有关,配置效率的提升与管理水平相关。
Objective To measure the fairness and efficiency of primary medical institutions in Guangdong, and to provide basic data and references for improving the operational efficiency of primary medical and health care institutions. Methods The Theil index was used to analyze the fairness of primary health resource allocation among regions in Guangdong. Horizontal and vertical analysis for the regions in Guangdong based on BCC-CCR model and Malmquist model of DEA. Results From 2014 to 2019,the primary medical institutions in 21 cities of Guangdong Province, which DEA efficient cities accounted for 28.6 %,scale efficiency was the main factor influencing comprehensive efficiency. The average change in the total factor productivity of primary medical institutions in Guangdong Province was-3.1%. The main reason for the low total factor productivity was the gradual growth of technological progress. Conclusions The regional differences of primary health resource allocation in Guangdong Province are obvious, the allocation of beds is not reasonable. High quality resources are clustered and uneven internal distribution in the Pear River Delta region. In terms of fairness, the fairness of primary health care resources allocation among different regions in Guangdong Province is low. In terms of efficiency, radiation effects in tertiary hospitals drive the improvement of comprehensive efficiency of primary health resources. The effectiveness of comprehensive efficiency is related to the technical efficiency, and the improvement of allocation efficiency is related to the management level.
作者
龙一天
甘奇慧
LONG Yi-tian;GAN Qi-hui(College of Humanities and Management,Guangdong Medical University,Dongguan 523808,China;Medical Security Research Institute,Guangdong Medical University,Dongguan 523808,China)
出处
《卫生软科学》
2022年第11期56-62,共7页
Soft Science of Health
基金
广州医科大学科研基金(GDMUM2020046)
广东医科大学人文与管理学院本科生科研项目基金(RW2021015)。
关键词
医疗卫生资源
公平与效率
泰尔指数
数据包络分析
medical and health resource
equity and efficiency
Theil index
data envelopment analysis
