College of Science, Zhejiang University of Science and Technology, Hangzhou, China.
The Third Department of Critical Care Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Provincial Center for Critical Care Medicine, Fujian Provincial Key Laboratory of Critical Care Medicine, Fuzhou, China.
BMC Health Serv Res. 2023 Jul 29;23(1):811. doi: 10.1186/s12913-023-09820-x.
The purpose of this study is to examine the development of healthcare services efficiency in China since the reform of the healthcare system. By examining the development environment of healthcare services in China and examining the driving factors affecting the efficiency of healthcare services, we provide a reference for the future high-quality development of healthcare services in China.
A three-stage super-efficient slack-based measure (SBM) model with undesirable outputs was used to measure the efficiency of healthcae services in 31 Chinese provinces from 2009 to 2021, and a global Malmquist-Luenberger (GML) index was used to assess their spatiotemporal evolution characteristics and internal influencing mechanisms of healthcare services efficiency.
The empirical results showed that the efficiency of China's healthcare services changed significantly from 2009-2014 and then remained stable. During the study period, the efficiency of healthcare services in the eastern region was higher than the national level, while it was lower in the western region. The results of the analysis of environmental factors indicated that an increase in population density reduced the redundancy of healthcare input resources and that economic development as well as an increase in government subsidies, contributed to an increase in the redundancy of healthcare input resources. The main contribution to the growth of healthcare sercices efficiency in China came from the technological innovation effect, and the growth was most significant in the western region.
From 2009 to 2021, the efficiency of national healthcare services generally showed a slow upward trend, and the efficiency of healthcare services varied widely among regions. Under the existing environmental constraints, relevant departments in each region should strengthen technological innovation in healthcare services, completely focus on the regional catch-up effect, and promote the balanced development of regional health.
本研究旨在考察医改以来中国医疗服务效率的发展。通过考察中国医疗服务发展环境，考察影响医疗服务效率的驱动因素，为未来中国医疗服务的高质量发展提供参考。
采用三阶段超效率 SBM 模型（带非期望产出）测算了 2009-2021 年中国 31 个省份的医疗服务效率，并利用全局 Malmquist-Luenberger（GML）指数测度了其时空演化特征及医疗服务效率的内部影响机制。
实证结果表明，中国医疗服务效率从 2009-2014 年发生显著变化，随后保持稳定。研究期间，东部地区医疗服务效率高于全国水平，而西部地区则较低。环境因素分析结果表明，人口密度的增加减少了医疗投入资源的冗余，经济发展以及政府补贴的增加，增加了医疗投入资源的冗余。中国医疗服务效率增长的主要贡献来自技术创新效应，且西部地区增长最为显著。
2009-2021 年，全国医疗服务效率总体呈缓慢上升趋势，且各地区医疗服务效率差异较大。在现有环境约束下，各地区相关部门应加强医疗服务技术创新，全面关注区域追赶效应，促进区域卫生均衡发展。
