湖南省公共医疗卫生支出效率及其影响因素实证分析

黄小平　刘美花

摘要利用DEATobit两阶段分析法，计算出20092013年5年间湖南省14个地级市政府公共医疗卫生支出的综合技术效率值、纯技术效率值、规模效率值三种效率值，分析出湖南省各地级市政府公共医疗卫生支出所处规模报酬阶段，并对反映卫生支出资金配置的综合技术效率水平的外部影响因素加以回归分析.结果发现：湖南省各地区公共医疗卫生效率水平整体水平偏低并且存在明显的差异性，除长沙以外的其他地级市政府公共医疗卫生支出均处于不同程度的非充分效率水平.湖南省各地区人均生产总值及城市化水平对公共医疗卫生支出效率有显著的促进作用.教育水平、人口密度、居民人均可支配收入对湖南省公共医疗卫生支出效率的提高有阻碍作用.

关键词医疗卫生支出；DEATobit分析方法；综合技术效率；纯技术效率；规模效率；影响因素

中图分类号 文献标识码A

AbstractThe comprehensive technical efficiency， pure technical efficiency and scale efficiency of public health expenditure from 2009 to 2013 in Hunan province were estimated by the DEATobit two phase analysis method， which shows the public health expenditure in Hunan province stands of the scale reward stage. At the same time， the external factors that reflect the comprehensive technical efficiency level of the fund allocation of health expenditure were analyzed. The results show that the overall level efficiency of public health level is low and there is an obvious difference in Hunan Province， and the efficiency of public health expenditure in other areas is low except in Changsha. The Per capita GDP and urbanization level in Hunan province have a significant promoting effect on the efficiency of public health expenditure. However， education level， population density， per capita disposable income of rural residents have a negative effect on the efficiency of public health expenditure.

Key wordsHealth expenditure；DEA-Tobit method；Comprehensive technical efficiency；Pure technical efficiency；Scale efficiency；Influence factor

1引言

随着我国经济和社会的快速发展以及政府职能的转变，政府的公共财政支出绝对量逐年增加.2009年我国开始了新一轮医疗卫生体制改革，各地方政府为了积极落实医疗卫生体制改革精神，纷纷加大对医疗卫生的投入，湖南省各级卫生部门逐步加强其基本公共卫生服务，对重大疾病进行全方位的防治，努力完善基层医疗服务体系，推进基本医疗保障体系建设，让个人承担医疗卫生支出费用有所下降，让人民群众“看病难、看病贵”的问题能够得到……