评估中国初级卫生保健机构的效率:改进的三阶段数据包裹分析方法
Wanmin Su1,2, Yatian Hou2, Mengge Huang2
1General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, 528244, Guangdong, People's Republic of China.
尽管进行了大量投资,但中国的初级医疗保健 (PHC) 效率在2012-2020年期间下降. 区域差异存在,东北地区的PHC效率最低. 需要有针对性的措施来改善医疗保健的提供.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 计量经济学 计量经济学
背景情况:
- 初级医疗保健 (PHC) 机构对于医疗保健系统的功能至关重要.
- 2009年中国的卫生改革刺激了大量的投资和举措,以提高PHC的效率.
- 本研究使用来自中国31个省份的2012-2020年小组数据来评估PHC机构的效率.
研究的目的:
- 评估中国初级卫生保健机构的效率.
- 确定影响PHC效率的因素.
- 为效率评估提供一种改进的分析方法.
主要方法:
- 应用一个改进的三阶段数据包裹分析 (DEA) 模型.
- 使用面向输入的全球超效率松式测量 (SBM) DEA模型.
- 考虑了环境因素,随机噪音,松和超高效率,以实现跨期的可比性.
主要成果:
- 由于环境因素和随机噪音,PHC效率被高估了.
- 从2012年到2020年,观察到PHC效率下降的趋势.
- 在效率方面发现了显著的区域差异,东北地区的效率最低.
- 主要影响因素包括收入,GDP,人口密度,年龄人口统计,教育水平和城市化.
结论:
- 对医疗保健机构的大量投资并没有带来预期的效率提高.
- 有效的本地化策略是必要的,以提高PHC在中国的效率.
- 该研究引入了一种新的DEA方法,适用于其他行业和国家.
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