| 引用本文：张培林, 谭华伟, 刘宪, 颜维华, 张云, 郑万会, 彭玲, 陈菲.医疗费用控制约束下医疗卫生资源配置绩效评价研究[J].中国卫生政策研究,2018,11(3):56-63 |
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| 医疗费用控制约束下医疗卫生资源配置绩效评价研究 |
| 投稿时间：2017-04-24 修订日期：2017-09-22 PDF全文浏览 HTML全文浏览 |
| 张培林1,2, 谭华伟1,2, 刘宪1,2, 颜维华1,2, 张云1,2, 郑万会1,2, 彭玲1,2, 陈菲3 |
1. 西南大学经管学院医院管理研究所 重庆 400700;
2. 重庆市医院成本管理研究中心 重庆 400700;
3. 重庆医科大学公共卫生与管理学院 重庆 400016 |
| 摘要:目的：评价医疗费用控制约束下2004-2015年中国医疗卫生资源配置绩效。方法：基于医疗费用控制约束构建投入产出绩效评价指标体系，运用非期望产出的SBM模型对医疗卫生资源配置效率水平进行测度。结果：全国和区域层面按非期望产出的SBM模型测算的医疗卫生资源配置效率均显著低于传统CCR模型；全国和区域层面非期望产出冗余率和期望产出不足率远大于卫生资源投入冗余率；区域内部各省份医疗卫生资源配置效率损失的原因不尽相同。结论：传统DEA模型高估了中国卫生资源配置的绩效，且对其变化特征敏感性较弱；非期望产出冗余和期望产出不足是中国卫生资源配置绩效损失的主要原因。应建立"投入-期望产出-非期望产出"一体化的医疗卫生资源配置绩效评价指标体系，开发与之契合的评价技术；并建立医疗卫生资源配置绩效考核与评价、监督与反馈机制，健全区域医疗卫生规划政策内涵。 |
| 关键词:医疗费用 卫生资源配置 绩效评价 |
| 基金项目:国家社会科学基金项目（14BGL112）；重庆市卫生经济学会招标课题（YWJK2016-8） |
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| Efficiency evaluation of China's heath resources allocation under medical expense control constraint |
| ZHANG Pei-lin1,2, TAN Hua-wei1,2, LIU Xian1,2, YAN Wei-hua1,2, ZHANG Yun1,2, ZHENG Wan-hui1,2, PENG Ling1,2, CHEN Fei3 |
1. Institute of Hospital Administration, College Economics and Management, Southwest University, Chongqing 400700, China;
2. Research Center for Hospital Cost Management of Chongqing, Chongqing 400700, China;
3. School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China |
| Abstract:Objective:The main objective of this study is to evaluate the efficiency of China's heath resources allocation during 2004 to 2015 under the constraint of medical expenses control. Methods:To evaluate the efficiency of China's heath resources allocation, the undesired output Slacks-Based Measure (SBM) model was used. Results:As per the findings of this study, the efficiency of heath resources allocation at the national and regional levels of the undesired output SBM model was significantly lower than that of the traditional CCR model during 2004 to 2015. The non-expected output redundancy rate and expected output deficiency rate at the national and regional levels were much greater than the input redundancy rate of health resources allocation of the national and regional levels. In addition, with redundancy rate introduction, the losses of health resource allocation efficiency in different provinces within the region were not the same. Conclusions:The efficiency of China's heath resources allocation was overestimated by the traditional DEA model, which was less sensitive to the change in its characteristics..Giving priority to non-expected output redundancy and expected output deficiency are the main reasons for the loss of health resource allocation in china, and are considered as internal and external improvement priorities for the performance of health resource allocation. It was suggested to establish the performance evaluation system of health resource allocation, which includes the integration of health resources input, expected-output and non-expected output, and evaluation techniques; and a mechanism for performance assessment and evaluation, supervision and feedback of health resource allocation should be established; and improve the implication of regional medical and health planning policies. |
| Key words:Medical expense Allocation of heath resources Efficiency evaluation |
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