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目的:探讨新医改背景下,山东省2015年社区卫生服务站资源配置效率变化情况。方法:利用数据包络分析,对山东省16个地市1 246家社区卫生服务站进行总体效率、技术效率和规模效率评价。结果:社区卫生服务站总体效率有效占比为14.00%,有8个地市的总体有效占比高于均值,多集中在西部地区;总体技术有效占比为34.00%,有63.00%的地市技术有效占比高于均值。东部的技术有效占比明显高于中西部地区;规模有效占比为14.00%,69.00%的地市规模有效占比高于均值,大城市的规模有效占比明显偏低。技术有效同时规模无效的规模报酬递增均数占比为59.84%,东西部占比相差悬殊;规模有效同时技术无效规模报酬递增的社区卫生服务站基本没有;规模无效约占86.00%,明显高于技术无效占比66.00%。结论:社区卫生服务站总体效率的提高源于规模效率的提升和政策导向,所以在调整社区卫生服务站的资源配置中,应因地制宜,根据区域情况加大基层医疗卫生资源的技术力量和规模投入。
Objective: To explore the change of resource allocation efficiency of community health service stations in Shandong Province in 2015 under the background of new medical reform. Methods: Data envelopment analysis was used to evaluate the overall efficiency, technical efficiency and scale efficiency of 1 246 community health service stations in 16 cities of Shandong Province. Results: The total effective rate of community health service stations was 14.00%. The total effective rates of eight cities and districts were higher than the average, mostly concentrated in the western region. The overall technical effective proportion was 34.00% with 63.00% of the cities The effective proportion of technology is higher than the average. The effective proportion of the eastern part of the technology was significantly higher than that of the central and western regions; the effective proportion of the effective scale of the cities was 14.00% and the effective proportion of 69.00% of the cities and cities was higher than the average value, while the effective proportion of large cities was obviously lower. The effective proportion of scale returns with both effective technology and invalid returns accounted for 59.84% of the total, while there was a big gap between east and west areas. There was basically no community health service station with effective scale returns and ineffective scale returns. The ineffectiveness rate was about 86.00%, significantly higher than Technology ineffective accounting for 66.00%. Conclusion: The improvement of overall efficiency of community health service stations is due to the promotion of scale efficiency and policy orientation. Therefore, in adjusting the resource allocation of community health service stations, the technical strength and scale investment of primary health care resources should be increased according to local conditions .