| 引用本文: |
仇蕾洁,仇腾飞,马安宁,等.山东省不同举办主体社区卫生服务站资源配置效率的区域比较研究[J].中国卫生经济,2017,(12):74-77.[点击复制] |
.Regional Comparative Study of Medical Resource Allocation Efficiency in Various Community Health Service Stations in Shandong Province[J].CHINESE HEALTH ECONOMICS,2017,(12):74-77.[点击复制] |
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| 摘要: |
| 目的：探讨在供给侧结构性改革的背景下，2015年山东省东中西部1246家9类社区卫生服务站的医疗资源配置效率情况。方法：利用数据包络分析，对山东省东中西部1246家9类社区卫生服务站进行总体效率、技术效率和规模效率评价。结果：社区卫生服务站总体效率有效占比为9.47%,中西部一级医院和乡镇卫生院转型社区卫生服务站占比高达58.33%和64.29%。东部二级医院转型和延伸社区卫生服务站占比为20.59%和25.00%；总体技术有效占比为23.27%，东部个人举办社区卫生服务站占比为50.55%，中西部一级医院和乡镇卫生院转型社区卫生服务站占比高于75.00%；总体规模有效占比为9.31%，东部和中西部占比几乎一致；技术有效同时规模无效的规模报酬递增均数占比为59.31%，东中西部占比相差悬殊，差值高达18.77%。东部政府和个人举办社区卫生服务站占比为73.68%和78.26%；规模有效同时技术无效的规模报酬递增的社区卫生服务站基本没有；规模无效约占50.84%，中西部各类无效率普遍高于东部。结论：山东省九类社区卫生服务站整体为外延式发展模式，服务定位不明确，资源配置极不合理，资源不足和浪费并存；各层级医疗机构呈“倒金字塔型”分布，数量严重不足、总体医疗资源配置效率偏低；东部二级医院转型和延伸的社区卫生服务站，与中西部一级医院和乡镇卫生院转型的社区卫生服务站是目前最适于基层的医疗卫生服务机构，东部基层医疗卫生机构存在层级断层现象；东中西部事业单位和企业高校举办的社区卫生服务机构在医疗卫生服务落实方面差异不大，配置效率偏低；政府举办的社区卫生服务站在技术有效方面更具发展潜力；东部个人举办的社区卫生服务站发展势头明显优于中西部，对该类机构应试行购买医疗卫生服务的管理模式。 |
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| Regional Comparative Study of Medical Resource Allocation Efficiency in Various Community Health Service Stations in Shandong Province |
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| Abstract: |
| Objective: Under supply-side structural reform, to explore medical resource allocation efficiency of 1246 community health service stations run by 9 ownerships in east-central-west Shandong province in 2015. Methods: Questionnaire method was used to analysis data about 1246 community health service stations run by 9 ownerships in east-central-west Shandong province. The analysis included overall efficiency, technical efficiency and scale efficiency evaluations. Results: The overall effective rate of community health service stations was 9.47%, among them, the proportions of central and western stations transformed by primary and township hospitals were up to 58.33% and 64.29%. In eastern region, the overall effective rates of stations transformed and extended by secondary hospitals were up to 20.59% and 25.00%. The overall technical effective rate was 23.27%, and the proportion of eastern community health services was 50.55%. In central and western regions, community health service stations held by primary and township hospitals had the highest proportion, which were more than 75.00%. The overall scale effective rate was 9.31%, of which, east-central-west regions shared almost the same proportion. The mean percentage of increasing returns to scale was 59.31%, when technology was effective and scale was invalid. Eastern and mid-western proportions differed greatly, and the difference was as high as 18.77%. Community health service stations run by eastern government and individuals, occupied 73.68% and 78.26%. There were no community health service stations which had increasing returns to scale, at the same time, scale was effective and technology was invalid. The proportion of invalid scale was about 50.84%, and mid-western different inefficiencies were generally higher than eastern area. Conclusions: Community health service stations run by 9 ownerships in Shandong province integrally were extension growing, at the same time, owned unclear service orientation, unreasonable resource allocation, insufficient resources and waste. Medical institutions at all levels took on inverted pyramid distribution. Their quantities w ere seriously inadequate and medical resource allocations w ere inefficient. The stations transformed and extended by mid-western primary and township hospitals, eastern secondary hospitals were most suitable for primary care health services currently. There were hierarchical faults in eastern primary medical and health institutions. In medical and health service implementation, east-central-west community health service organization s run by public institution, enterprise and college had little difference. Meanwhile, their resource allocation efficiency was very low. Community health service stations organized by government had more potential in effective technology. Eastern private stations’ momentum was obviously better than that in the mid-west. The government should try to purchase medical and health services from such institutions |
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