空间视域下中国基层医疗卫生机构服务效率及影响因素研究
Study on service efficiency and influencing factors of primary health care institutions in China from the spatial perspective
投稿时间:2022-09-06  修订日期:2022-09-25
DOI:
中文关键词:  基层医疗卫生机构  服务效率  三阶段DEA  空间计量回归
English Keywords:Primary health care institutions  Service efficiency  three-stage DEA  Spatial econometric
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作者单位邮编
蔡武* 南华大学 421001
王连丽 南华大学 421001
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中文摘要:
      提升基层医疗卫生机构服务能力已成为我国现阶段新医改的关键内容。本文基于2011-2020年我国基层医疗卫生机构相关数据,采用三阶段DEA方法测度我国基层医疗卫生机构服务效率,结合ArcGIS软件分析其空间分布规律,并在此基础上使用空间计量模型分析了影响基层医疗卫生机构服务效率的重要因素。研究发现:(1)乡镇卫生院服务效率均值(0.939)高于社区卫生服务中心服务效率均值(0.891),其中乡镇卫生院有13个省份、社区卫生服务中心有7个省份的服务效率值均为1,处于技术有效状态。(2)ArcGIS分析表明,乡镇卫生院服务效率有超过85%的省份位于第一级、第二级和第三级,且各层级差异明显,而社区卫生服务中心服务效率除第一级分布11个省份和第四级分布2个省份外,其余分级数量较为均衡。(3)相邻省份间基层医疗卫生机构服务效率存在正向相互影响。(4)医师诊疗均数对社区卫生服务中心和乡镇卫生院服务效率的影响均显著为正,而管理人员占比对其服务效率的影响均显著为负。(5)医护比对乡镇卫生院服务效率的影响显著为正,而对社区卫生服务中心服务效率的影响显著为负。基于上述结论,本文提出了提高基层医疗卫生机构服务效率的政策启示。
English Summary:
      Improving the service capacity of primary medical and health institutions has become the focus of China"s new medical reform. Based on the panel data from 2011 to 2020, the three-stage DEA method was used to measure the service efficiency, the spatial law was analyzed by ArcGIS software, and the important influencing factors were analyzed by spatial econometric model. The results showed that :(1) the average service efficiency of township health centers was higher than that of community health centers. The service efficiency value of township health centers and community health centers was 1 in 13 and 7 provinces, respectively, which was in the state of technical effectiveness. (2) ArcGIS analysis showed that the service efficiency of more than 85% of township hospitals in provinces was at level 1, 2 and 3, and there were significant differences among different levels. The service efficiency of community health centers was distributed in 11 provinces of grade 1 and 2 provinces of grade 4, and the number of other levels was relatively balanced. (3) There is a positive interaction between the service efficiency of primary medical and health institutions in neighboring provinces. (4) The average value of doctors" diagnosis and treatment had a significantly positive effect on the service efficiency of community health service centers and township hospitals, while the effect of the proportion of managers was significantly negative. (5) The effect of physician ratio on the service efficiency of township health centers was significantly positive, and the effect on the service efficiency of community health service centers was significantly negative. Based on the above conclusions, this paper puts forward policy recommendations to improve the service efficiency of primary medical and health institutions.
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