我国健康服务生产效率的区域差异和动态演进OA

Objective To clarify the regional differences and dynamic evolution of health service produc-tion efficiency at the provincial level of China,and to explore suggestions for efficiency improvement.Methods The results of health service production efficiency of 31 provinces in China from 2012 to 2021 were statistically measured,with the use of the undesired output super-efficiency SBM model.The Dagum Gini coefficient was a-dopted to measure the differentiation of health service production efficiency of China,for investigating the charac-teristics and sources of the efficiency differences.The Markov chain model was applied to predict the dynamic evo-lution of efficiency differences.Results The overall health service production efficiency in China was relatively high,with an average efficiency of 0.938.The eastern region(1.001)was in the lead,followed by the central re-gion(0.977)and the western region(0.854)in descending order.The Gini coefficient showed a fluctuating trend of"up-down-up",and the regional difference gradually increased,with the greatest contribution of hyper-variable density(41.48％),followed by intra-regional(32.54％)and inter-regional(26.28％)differences.The production efficiency of health services in China was polarized and relatively stable,and there were few effi-ciency mutations among different levels.Conclusions The health service production efficiency in China is gener-ally high,but there is still regional imbalance.Regional disparities are widening,with hypervariable density difference being the primary contributing factor.There is polarization in health service production efficiency,along with spatial spillover effects.The provinces with high efficiency are prone to be affected by the surrounding prov-inces with low efficiency,presenting a phenomenon of"convergence to the bottom".