我国卫生资源配置公平性及使用效率研究

【作者】 李飞；

【导师】 郭有德；

【作者基本信息】 复旦大学 ， 人口、资源与环境经济学， 2013， 硕士

【摘要】 本文从公平性和效率性,对我国卫生资源展开研究。公平性方面,从物力、人力、财力方面选取医院和卫生院数、医院和卫生院床位数、医生数、财政卫生支出为卫生资源代表指标,采用基尼系数分析我国卫生资源配置的地区不均等性,结果显示,医生数的地区不均等性较大。以泰尔指数将全国卫生资源不均等性分解为三大地区间不均等性、地区内各省级行政地区间不均等性、省内地级市间不均等性三个层次,研究我国卫生资源地区不均等性的内部构成。通过理论原理和实际计算结果两方面,对比泰尔T指数和泰尔L指数,本文认为泰尔L指数在反应我国卫生资源差距时更加科学。根据泰尔L指数结果,省内的不均等性是我国卫生资源配置地区不均等性的最主要来源,其次是地区内不均等性,最后是地区间不均等性。效率性方面,本文选取围产儿死亡率和孕产妇死亡率为卫生指标代表,并作为因变量,以人均财政卫生支出的自然对数为自变量,运用计量经济学面板数据回归方法,对我国31个省级行政地区的历年相关数据,采用个体固定效应回归形式作回归分析,研究各省级行政地区财政卫生支出对卫生指标的改善效果。结果显示,中、西部社会经济欠发达地区的改善效率,相比东部沿海地区更高。这对提高财政卫生支出具有重要的意义,将改善效率较低的东部省份财政卫生支出,部分转移给中西部改善效率较高地区,将实现我国财政卫生支出的帕累托改进。更多还原

【Abstract】 This paper takes research on health resources in China’s mainland in two aspects, equity and efficiency. Regarding equity, the number of hospitals and health centers, number of beds of hospitals and health centers, and number of doctors are selected as the indicators of health resources. Gini Coefficient is employed to evaluate the equity of health resources’ allocation in China’s mainland, which gets to a conclusion that the gap of doctor’s number is quite large. Theil index is used to decompose the health resources’ total disparity into three parts, inter-regional (eastern, central, and western China), inter-provincial within each region, and inner-provincial disparity. Both theoretical principle and practical calculation indicate that Theil-L index is more accurate than Theil-T index in reflecting health resources disparity in China. According to Theil-L index, inner-provincial disparity is the most significant contributor, followed by inter-provincial, and finally inter-regional.In aspect of efficiency, this paper selected perinatal mortality and maternal mortality rate as the dependent variables, and the natural logarithm of fiscal expenditure on health per capita as independent variable. Econometric panel data regression method is used to analyze the efficiency of fiscal expenditure on health. The individual fixed effect regression result shows that the less developed provinces in Midwest China perform significantly better than those in the eastern region. This will greatly help enhancing the efficiency of fiscal expenditure on health. By removing the health expenditure from Midwest to East China, from the relatively lower efficiency areas to the higher areas, we will achieve Pareto improvement on the allocation of fiscal expenditure on health.更多还原