Li Zhengjun, Yang Lili, Tang Shaoliang, Bian Yaoyao
College of Health Economics Management, Nanjing University of Chinese Medicine, Nanjing, China.
School of Management, University of St Andrews, St Andrews, United Kingdom.
Front Public Health. 2020 Dec 15;8:579269. doi: 10.3389/fpubh.2020.579269. eCollection 2020.
In this study, we aimed to estimate the equity and efficiency of traditional Chinese medicine (TCM) health resource allocation, utilization, and trend in mainland China from 2013 to 2017. The data were downloaded from the China Health Statistical Yearbook (2014-2018) and the China Statistical Yearbook (2018). The equity of TCM health resource allocation was evaluated through the Lorenz curve, Gini coefficient (G), and Theil index (T) based on population size and geographical area. The efficiency and productivity of TCM health resource utilization were assessed using the data envelopment analysis-based Malmquist productivity index. TCM health resource had an increasing trend every year. The equity allocated by population (G ranging from 0.1 to 0.3) was better than that by geographic region (G > 0.5). T in the intra-groups was higher than those in the inter-groups. The equity of TCM resource allocation was the middle region > eastern region > western region. Most provinces (29 out of 31) had negative productivity changes, suggesting deterioration in productivity. Moreover, the middle region with higher scale sizes had more redundant inputs than the other two regions. However, the low technological development (all technical values <1) might hinder productive progress. The equity of TCM health allocated by the population was better than that by the geographic region. The intra-regional difference was the main reason for inequity sources. Productivities in more than 97% of provinces are inefficient. The frequency distribution of scale efficiency (score > 1) had increased since 2015. However, the frequency distribution of technical change (score > 1) decreased every year. The slow technological progress and low scale size might be the main reasons for low productivity.
在本研究中，我们旨在评估2013年至2017年中国大陆地区中医药卫生资源配置、利用情况及趋势的公平性和效率。数据下载自《中国卫生统计年鉴》（2014 - 2018年）和《中国统计年鉴》（2018年）。基于人口规模和地理区域，通过洛伦兹曲线、基尼系数（G）和泰尔指数（T）评估中医药卫生资源配置的公平性。使用基于数据包络分析的Malmquist生产率指数评估中医药卫生资源利用的效率和生产率。中医药卫生资源每年呈增长趋势。按人口分配的公平性（G值在0.1至0.3之间）优于按地理区域分配的公平性（G > 0.5）。组内的泰尔指数高于组间。中医药资源配置的公平性为中部地区>东部地区>西部地区。大多数省份（31个中的29个）生产率变化为负，表明生产率下降。此外，规模较大的中部地区比其他两个地区有更多的冗余投入。然而，技术发展水平较低（所有技术值<1）可能阻碍生产进步。按人口分配的中医药卫生公平性优于按地理区域分配的公平性。区域内差异是不公平来源的主要原因。超过97%的省份生产率低下。自2015年以来，规模效率（得分>1）的频率分布有所增加。然而，技术变化（得分>1）的频率分布逐年下降。技术进步缓慢和规模较小可能是生产率低下的主要原因。
