广东省基本医疗保险制度运行效率评价

Efficiency evaluation of the operation of Guangdong Province's basic medical insurance system

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原文链接

国家科技期刊平台
NETL
NSTL
万方数据

中文摘要：目的评估2017-2021年广东省21个地级市基本医疗保险制度的运行效率,探讨环境变量对制度运行效率的影响.方法使用面板三阶段数据包络分析法,取各地级市2017-2021年医保相关数据,评价其运行效率并分析环境变量对制度运行效率的影响,在剥离环境因素和随机误差影响之后,再次评价其综合技术效率、纯技术效率和规模效率.结果随机误差和环境因素对各地级市基本医疗保险制度的运行效率存在显著影响,其中社工资源供给水平与制度运行效率呈正相关,而经济发展水平、人口老龄化水平、医疗设施资产供给水平与制度运行效率呈负相关.结论基本医保制度的运行效率在地级市间存在较大差异,且表现为规模无效率;医疗资源配置结构失衡、医疗服务供需不匹配可能是造成基本医保制度运行规模报酬递减的重要原因,也可能是导致经济发展水平和医疗设施资产供给水平与制度运行效率呈负相关的原因所在;优化社工资源是提升基本医保制度运行效率的有效手段;基本医保制度的运行面临人口老龄化挑战.建议进一步优化医疗资源配置,进一步加强社会工作者队伍建设,进一步加快全面推进医养结合发展.

外文摘要：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.

外文关键词：

Basic medical insuranceOperational efficiencyData envelopment analysisStochastic fron-tier analysisPanel three-stage DEASFA regression

作者：

许潇栋、胡杨木、范阳东

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作者单位：

广州医科大学卫生管理学院,广东广州 511436

关键词：

基本医疗保险运行效率数据包络分析随机前沿分析面板三阶段DEA SFA回归

基金：

广东省高校基于大数据利用的卫生健康治理哲学社会科学重点实验室广东省哲学社会科学规划基金项目

项目编号：

2023WSY007GD22CYJ27

出版年：

2024

DOI：

10.19955/j.cnki.1005-5916.2024.09.005

中国农村卫生事业管理

中华预防医学会

中国农村卫生事业管理

影响因子：0.744

ISSN：1005-5916

年,卷(期)：2024.44(9)