Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410078, China.
Department of Primary Health Care, Health Commission of Hunan Province, Changsha 410078, China.
Int J Environ Res Public Health. 2020 Mar 9;17(5):1781. doi: 10.3390/ijerph17051781.
This study aimed to estimate the efficiency and its influencing factors of Primary Health Care Institutions (PHCIs) in counties in Hunan Province, China, and put forward feasible suggestions for improving the efficiency of PHCIs in Hunan Province. We applied the Input-Oriented Data Envelopment Analysis (DEA) method and the Malmquist Index Model to estimate the efficiency of PHCIs in 86 counties in Hunan Province from 2009 to 2017. Then, the Tobit model was used to estimate the factors that influence the efficiency of PHCIs. Since the implementation of the new health-care reform in 2009, the number of health resources in PHCIs in Hunan Province has increased significantly, but most counties' PHCIs remain inefficient. The efficiency of PHCIs is mainly affected by the total population, city level, the proportion of health technicians and the proportion of beds, but the changes in per capita GDP have not yet played a significant role in influencing efficiency. In the future, the efficiency of PHCIs should be improved by increasing medical technology skills and enthusiasm of health technicians and by improving the payment policies of medical insurance funds.
本研究旨在评估中国湖南省县级基层医疗保健机构（PHCIs）的效率及其影响因素，并为提高湖南省 PHCIs 的效率提出可行的建议。我们应用投入导向型数据包络分析（DEA）方法和 Malmquist 指数模型，对 2009 年至 2017 年湖南省 86 个县的 PHCIs 效率进行了评估。然后，采用 Tobit 模型估计影响 PHCIs 效率的因素。自 2009 年新医改实施以来，湖南省 PHCIs 的卫生资源数量显著增加，但大多数县的 PHCIs 仍效率低下。PHCIs 的效率主要受到总人口、城市级别、卫生技术人员比例和床位比例的影响，但人均 GDP 的变化尚未对效率产生显著影响。未来，应通过提高卫生技术人员的医疗技术技能和积极性，以及改进医疗保险基金的支付政策，提高 PHCIs 的效率。
