目的 探讨我国省际卫生服务效率现状及提升对策.方法 基于 《2010中国卫生统计年鉴》,从我国内地31个省(市、自治区)中选取2009年统计资料包括以下分析指标的18个省(市、自治区)为研究对象,包括北京、天津、河北、山西、黑龙江、上海、江苏、浙江、福建、江西、山东、湖北、广东、云南、甘肃、青海、宁夏、新疆.采用数据包络分析(DEA)法对18个省(市、自治区)的卫生服务效率进行分析.其中投入指标包括卫生经费(元)、每千人拥有床位数(张)、每千人拥有卫生技术人员数(人)、每千人拥有医师数(人)、每千人拥有护士数(人)5项;产出指标包括死亡率(‰)和出生率(‰)2项.结果 归属于第1类的省(市、自治区)共有4个:河北、江西、云南、甘肃,其对应的综合技术效率分别为0.944、1.000、1.000、1.000.归属于第2类的省(市、自治区)共有3个:江苏、福建、湖北,其对应的综合技术效率分别为0.878、0.850、0.831.归属于第3类的省(市、自治区)共有8个:山西、黑龙江、浙江、山东、广东、青海、宁夏、新疆,其对应的综合技术效率分别为0.719、0.623、0.619、0.728、0.628、0.796、0.759、0.688;归属于第4类的省(市、自治区)共有3个:北京、天津、上海,其对应的综合技术效率分别为0.248、0.496、0.388.对归属于第3、4类的11个省(市、自治区)进一步改进效率显示,在产出不变的情况下,除青海省、新疆维吾尔自治区无需调整任何投入指标外,其余9个省(市、自治区)均需减少卫生经费,小幅压缩或微调"每千人拥有床位数""每千人拥有卫生技术人员数量""每千人拥有医师数""每千人拥有护士数".结论 我国省际卫生服务效率间存在差异,部分省(市、自治区)的卫生服务效率需要进一步提升,可从经费、人员、硬件设备等方面进行改善.%Objective To discuss current status of inter - provincial health service efficiency of China and its promotion countermeasure. Methods Based on China Health Statistical Yearbook in 2010,18 provinces (municipalities and autonomous regions)from 31 provinces (municipalities and autonomous regions)of mainland China were selected as objects of study, including Beijing, Tianjin, Hebei, Shanxi, Heilongjiang, Shanghai, Jiangsu, Zhejiang, Fujian, Jiangxi, Shandong,Hubei,Guangdong,Yunnan,Gansu,Qinghai,Ningxia and Xinjiang,and their inclusion criteria was that they included the following input and output indicators in the statistical material of 2009. Data envelopment analysis (DEA)was used to analyze the efficiency of health services in 18 provinces (municipalities and autonomous regions). The input indicators included the following 5 items:health expenditure (yuan),the number of owned beds per thousand people,the number of owned health technicians per thousand people,the number of owned doctors per thousand people,the number of owned nurses per thousand people;the output indicators included two items - mortality (‰)and birth rate (‰). Results There were four provinces (municipalities and autonomous regions)belonging to the first category:Hebei,Jiangxi,Yunnan,and Gansu,and their corresponding integrated technical efficiencies were 0. 944,1. 000,1. 000 and 1. 000 respectively. Three provinces (municipalities and autonomous regions ) belonged to the second category: Jiangsu, Fujian, and Hubei, and their corresponding integrated technical efficiencies were 0. 878, 0. 850, and 0. 831 respectively. There were 8 provinces (municipalities and autonomous regions ) belonging to the third category:Shanxi,Heilongjiang, Zhejiang, Shandong, Guangdong,Qinghai,Ningxia,and Xinjiang,and their corresponding comprehensive technical efficiencies were 0. 719, 0. 623,0. 619,0. 728,0. 628,0. 796,0. 759,and 0. 688 respectively;three provinces (municipalities and autonomous regions)belonged to the fourth category:Beijing,Tianjin,and Shanghai,and their corresponding integrated technical efficiencies were 0. 248,0. 496, and 0. 388 respectively. Further improvement of the efficiency of those 11 provinces (municipalities and autonomous regions)that belonged to the third and fourth categories showed as follows,in the case of constant output,only Qinghai Province and the Xinjiang Uygur Autonomous Region needed not have to adjust their input indicators,the remaining nine provinces (municipalities and autonomous regions)all needed to reduce health expenditure,and slightly compress or fine - adjust " the number of owned beds per thousand people"," the number of owned health technicians per thousand people"," the number of owned physicians per thousand people",and " the number of owned nurses per thousand people" . Conclusion There are differences in the efficiency of inter - provincial health services of China,and the efficiency of health services in some provinces (municipalities and autonomous regions)needs to be further improved from aspects of expenditure,personnel,and hardware equipment.
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