中国全科医学2018，Vol.21Issue(4)：390-394,400,6.DOI:10.3969/j.issn.1007-9572.2018.04.004
基于共时与历时两个维度的我国社区卫生服务中心卫生服务效率研究
Efficiency of Community Health Service Centers in China during 2013-2015: a Synchronic and Diachronic Study
摘要
Abstract
Objective We explored the efficiency of community health service centers (CHSCs) in China from 2013 to 2015, providing policy suggestions for optimizing the allocation of health resources. Methods From 3 volumes of China's Health and Family Planning Statistical Yearbook (2014—2016), we collected the data about the efficiency of CHSCs in 30 provinces (autonomous regions/municipalities) in mainland China (except Tibet) from 2013 to 2015. Data envelopment analysis (DEA) and Malmquist index analysis were performed to investigate the dynamic changes in the efficiency of these CHSCs during this period at the national level as well as the provincial level. The input indicators include the numbers of CHSCs, primary care providers and beds. The output indicators consist of visits, number of inpatients, occupancy rate of beds and average length of stay. Results In 2015, the average national comprehensive technical efficiency, average national pure technical efficiency and average national scale efficiency of CHSCs were 0.715, 0.705 and 0.972 respectively; Eight regions (Guangdong, Guizhou, Hainan, Ningxia, Qinghai, Shanghai, Zhejiang and Chongqing, accounting for 26.7%) owned effective comprehensive technical efficiency with a value of 1.000, the other 22 regions had an average surplus 131 CHSCs, 5 573 primary care providers and 2 086 beds. Compared with 2013, in 2015, the average national technical efficiency change index of CHSCs was 0.990, decreased by 1.0%, average national technical change index of CHSCs was 1.034, increased by 3.4%, average national pure technical efficiency change index of CHSCs was 1.002, increased by 0.2%, average national scale efficiency change index of CHSCs was 0.988, decreased by 1.2%, the total factor productivity of CHSCs was 1.024, increased by 2.4%. Conclusion From 2013 to 2015, the efficiency of CHSCs generally presented a rising trend at the national level, but it also displayed obvious provincial-specific differences. In the areas owning inefficient CHSCs identified by DEA analysis, there was a problem of coexistence of insufficiency and waste of community health resources. In view of this, targeted measures should be taken to optimize the allocation of community health resources, and the management level of CHSCs should be strengthened in order to improve the efficiency of these institutions.关键词
社区卫生服务中心/数据包络分析/效率/全要素生产率Key words
Community health service center/Data envelopment analysis/Efficiency/Total factor productivity分类
医药卫生引用本文复制引用
赵临,张瑶,侯亚冰,闫贵明..基于共时与历时两个维度的我国社区卫生服务中心卫生服务效率研究[J].中国全科医学,2018,21(4):390-394,400,6.基金项目
国家自然科学基金资助项目(71704130) （71704130）
中国博士后科学基金特别资助项目(2016T90211) （2016T90211）
