应用DEA方法评测中国各地区健康生产效率

本文将地区健康系统视为健康生产决策单元,通过数据包络分析方法(DEA)对地区健康生产进行效率评测和影响因素分析。我们发现:各年份处于生产前沿面上的省份各不相同,而远离前沿面的省份基本一致,总体而言平均健康生产效率不断提高;根据效率和产出可以将全国划分为六类具有不同的效率提高路径的地区;健康生产效率在东、中、西部,东、西部和东、中部之间存在显著差异;地区人口密度与健康生产效率之间存在显著的相关关系,公共健康投入比例与健康生产效率之间呈现并不十分显著的负相关关系,这可能是公共财政支出不当偏重倾向的结果;城乡居民在支付能力与健康生产效率之间的关系上恰好相反,这可能与城乡之间截然不同的收入水平和公共服务待遇相关,因而应当采取有针对性的医疗卫生政策。

Using Data Envelopment Analysis Approach to Estimate the Health Production Efficiencies in China

By using Data Envelopment Analysis approach, we treat the health production system in a certain province as a Decision Making Unit (DMU), identify its inputs and outputs, evaluate its technical efficiency in 1982, 1990 and 2000 respectively, and further analyze the relationship between efficiency scores and social-environmental variables. This paper has several interesting findings. Firstly, provinces on frontier in different year are different, but provinces far from the frontier keep unchanged. The average efficiency of health production has made a significant progress from 1982 to 2000. Secondly, all provinces in China can be divided into six categories in terms of health production outcome and efficiency, and each category has specific approach of improving health production efficiency. Thirdly, significant differences in health production efficiencies have been found among the eastern, central and western regions in China, and among the eastern and central regions. At last, there is significant positive relationship between population density and health production efficiency but negative relationship (not very significant) between the proportions of public health expenditure in total expense and efficiency. Maybe it is the result of inappropriate tendency of public expenditure. The relationship between abilities to pay for health care services and efficiency in urban areas is opposite to that in rural areas. One possible reason is the totally different income and public services treatments between rural and urban residents. Therefore, it is necessary to adjust health policies and service provisions which are specifically designed to different population groups.