Efficiency evaluation of the operation of Guangdong Province's basic medical insurance system
Objective To evaluate the operational efficiency of the basic medical insurance system in 21 prefecture-level cities of Guangdong Province from 2017 to 2021 and to explore the impact of environmental varia-bles on the efficiency of the system operation.Methods Using the panel three-stage data envelopment analysis(DEA)method,relevant medical insurance data from each prefecture-level city from 2017 to 2021 were collected to evaluate their operational efficiency and analyze the impact of environmental variables on the efficiency of the system operation.After removing the effects of environmental factors and random errors,the comprehensive techni-cal efficiency,pure technical efficiency,and scale efficiency were re-evaluated.Results Random errors and en-vironmental factors significantly influenced the operational efficiency of the basic medical insurance system in each prefecture-level city.The supply level of social work resources was positively correlated with the efficiency of sys-tem operation,while the level of economic development,population aging,and the supply of medical facility assets were negatively correlated with the efficiency of system operation.Conclusions There is significant difference in the operational efficiency of the basic medical insurance system among prefecture-level cities,manifested as scale inefficiency.Imbalances in the allocation structure of medical resources and mismatches between supply and de-mand for medical services may be important reasons for the decreasing returns to the operation scale of the basic medical insurance system.They may also be the reasons for the negative correlation between the level of economic development,the supply of medical facility assets and the efficiency of the system operation.Optimizing social work resources is an effective means to improve the operational efficiency of the basic medical insurance system,and the operation faces the challenge of population aging.It is recommended that medical resource allocation be further optimized,the construction of the social worker team strengthened,and the comprehensive promotion of the integration of medical care and elderly care was accelerated.