京津冀协同背景下公共医疗卫生支出绩效差异实证

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1、中央财经大学学报2015年第4期·财政税收·京津冀协同背景下公共医疗卫生支出绩效差异实证分析AnEmpiricalAnalysisofthePerformanceDifferencesinPublicHealthSpendingundertheCoordinatedDevelopmentofBeijing-Tianjin-Hebei王丽王晓洁WANGLiWANGXiao-jie［摘要］随着京津冀一体化的不断推进，缩小京津冀间的经济社会差距既成为公共服务均等化的公民诉求，也成为增强京津冀城市群整体竞争力

2、、实现京津冀长效协同发展的迫切态势需求。而公共医疗卫生作为典型的民生公共服务，政府具有显性化的责任，为了探究京津冀间公共医疗卫生支出效率的差异诱因，以助推京津冀城市群医疗卫生的协同发展，笔者运用数据包络分析方法以及Malmquist生产率指数，评价分析了京津冀城市圈中13个城市的公共医疗卫生投入与产出的效率水平及变动情况，并将京、津、冀三个地区进行了横向差异比较。实证结果表明，河北与北京、天津相比，确实存在支出效率较低的差距，但差距正在逐渐缩小;北京与天津已经处于规模报酬递减阶段，但河北大部分城市仍处

3、于规模报酬递增阶段。根据实证分析结果，笔者提出京津冀应均衡区域发展、控制医疗支出规模增长、统一医疗卫生政策等建议，以进一步提高医疗卫生支出绩效。［关键词］京津冀医疗卫生支出效率差异DEAMalmquist指数［中图分类号］F812.45［文献标识码］A［文章编号］1000－1549(2015)04－0003－08Abstract:WiththecontinuousadvanceofBeijing-Tianjin-Hebeiintegration，narrowingthegapbetweentheeco

4、nomyandsocietyofBeijing-Tianjin-Hebeihasbeentheneedsofequalizationofpublicservicesforciti-zens，andtheurgentneedsoftheBeijing-Tianjin-Hebeicitygrouptostrengthentheoverallcompetitivenessandachievelong-termcooperativedevelopment．Sincepublichealthisatypical

5、publicserviceforthepeople'slivelihood，governmenthasexplicitresponsibilityforit．InordertopromotethecollaborativedevelopmentofBeijing-Tianjin-Hebeicitygroup，thepaperexploredthedifferencesandtheboostingincentivesofthepublichealthexpenditureefficiencyinBeij

6、ing，TianjinandHebei.ThispaperusedDEAmethodsandMalmquistin-dex，evaluatedandanalysedtheefficiencylevelsandchangesofpublichealthexpenditurefor13citiesofBei-jing-Tianjin-Hebei，andmadethehorizontaldifferencecomparison．TheempiricalresultsshowthatHebeihasalowe

7、rspendingefficiencygapcomparingwithBeijingandTianjin，butthegapisgraduallynarrowing．Bei-jingandTianjinarealreadyinthestageofdecreasingreturnstoscale，butmostcitiesinHebeiarestillinthestageofincreasingreturnstoscale．Accordingtotheempiricalresults，weshouldb

8、alanceregionaldevelop-mentofBeijing-Tianjin-Hebei，controlthehealthexpenditurescalegrowth，unifyhealthpolicyandsoon，tofurtherimprovetheefficiencyofhealthexpenditure．Keywords:Beijing-Tianjin-HebeiTheefficiencyofpublichealthexpenditu