Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
International College of Business and Technology, Tianjin University of Technology, Tianjin 300384, China.
Int J Environ Res Public Health. 2018 Oct 16;15(10):2265. doi: 10.3390/ijerph15102265.
The objective of this paper is to analyze the provincial efficiency of the Chinese community health care service and its differences. This study allows us to predict the provincial differences in the efficiency of the Chinese community health care service from 2017 to 2026. This study analyzes the contributions of inter-regional and intra-regional differences in the total efficiency difference. We use the Super-SBM (Slacks-based Model) data envelopment analysis (DEA) model, Grey Model GM (1,1) for grey prediction, and the group-based Theil index decomposition method to study Chinese provincial panel data from 2008 to 2016. Results show that a fluctuating trend existed in the average provincial efficiency of community health services from 2008 to 2016. The community health services in a considerable number of provincial areas were inefficient. This study also reveals that there existed apparent inter-provincial differences in efficiency in Chinese community health services. The inter-provincial differences of the efficiency of Chinese community health services revealed by the Theil index declined at a relatively slow pace. With regard to the provincial efficiency difference of the Chinese community health service, the intra-regional efficiency difference is the most important structural reason for the overall efficiency difference, which explains the overall difference to a large extent. The inter-regional efficiency difference among the eastern, central, and western regions becomes the secondary structural reason, which should not be ignored. In conclusion, focus should be put on restructuring the investments into medical resources for community health service in each Chinese province. More attentions should be put into narrowing the inter-regional efficiency differences of the Chinese provincial community health service. The strategies targeted at reducing the inter-regional efficiency differences should not be ignored, so as to facilitate the improvement of overall efficiency of the Chinese community health service.
本文旨在分析中国社区卫生服务的省级效率及其差异。本研究允许我们预测 2017 年至 2026 年中国社区卫生服务效率的省级差异。本研究分析了总效率差异中区域间和区域内差异的贡献。我们使用超 SBM（基于松弛的模型）数据包络分析（DEA）模型、灰色预测 GM（1,1）和基于群组的泰尔指数分解方法，研究了 2008 年至 2016 年中国省级面板数据。结果表明，2008 年至 2016 年，社区卫生服务的平均省级效率呈波动趋势。相当多省级地区的社区卫生服务效率低下。本研究还揭示了中国社区卫生服务效率存在明显的省际差异。泰尔指数揭示的中国社区卫生服务效率的省际差异下降速度相对较慢。就中国社区卫生服务的省级效率差异而言，区域内效率差异是整体效率差异的最重要结构原因，在很大程度上解释了整体差异。东部、中部和西部地区之间的区域间效率差异成为次要结构原因，不容忽视。总之，应注重调整中国各省社区卫生服务医疗资源投入结构。应更加关注缩小中国省级社区卫生服务的区域间效率差异。不应忽视针对减少区域间效率差异的战略，以促进中国社区卫生服务整体效率的提高。
