摘要
目的:分析我国医疗服务效率的时空演进趋势及影响因素,为提高医疗服务效率提供一定参考.方法:基于DEA-Malmquist模型测算医疗服务效率,通过双向固定的面板Tobit模型识别医疗服务效率的影响因素.结果:时间尺度上,2009-2020 年技术进步指数变化幅度在 0.882-1.024,均值为 0.949.空间尺度上,31 个省份的技术进步指数均小于1,均值呈现"东部>西部>中部"的特征.影响因素上,医疗服务效率受到区域外部环境和医院内部环境共同影响.结论:医疗服务效率主要因技术创新能力不足而在时间尺度上折损,在空间尺度上区域失衡.医院住院人数、医院门诊医药费用、区域人口密度、老龄化程度会导致效率折损,注册护士数量、财政自主性则会促进效率改善.因此,需要从"政府-医院"的二元视角入手,采取技术赋能、制度约束、资源调配、资金支持、人才吸纳等措施提高医疗服务效率.
Abstract
Objective:To analyze the spatio-temporal evolution trend and influencing factors of healthcare service efficiency in China,so as to provide references for mangers to enhance healthcare service efficiency.Methods:Healthcare service efficiency was measured with the DEA-Malmquist model.The influencing factors were identified through a two-way stationary panel Tobit model.Results:On temporal scale,the technological progress indexes ranged from 0.882 to 1.024 during 2009-2020,with an average of 0.949.On spatial scale,the technological progress indexes of 31 provinces were all less than 1,with the average value characterized by"East>West>Central".On influencing factors,healthcare service efficiency was affected by external region environment and internal hospital environment.Conclusion:Due to the lack of technological innovation ability,healthcare services efficiency shows a trend of loss on the temporal scale,and regional imbalance on the spatio scale.The number of hospital inpatients,hospital outpa-tient medical expenses,regional population density,and the aging can jeopardize healthcare services efficiency,while the number of registered nurses and financial autonomy can promote it.So we should start from the"Government-Hospital"dual perspective,and implement some measures,including technological empowerment,institutional constraints,resource allocation,financial sup-port and talent absorption,thus enhancing healthcare service efficiency.
基金项目
国家卫生健康委员会规划发展与信息化司健康中国建设揭榜攻关项目(JKZGJBGG2329)
维普
万方数据