Study On The Supply Efficiency Of China’s Rural Medical And Health Service

With the continuous improvement of the new medical reform policy,China’s governments have achieved remarkable success and built up a coverage of urban and rural health service system at all levels with the increase of investment in rural health.However,rural health care in China is not optimistic,those problems such as it’s difficult and expensive to get treated have not been fundamentally resolved.How to make the use of fiscal funds,and improve the efficiency of primary health care resources so that to avoid waste of resources when inadequate resources in the meantime is the key to health care reform and health care development.This paper try to analyzes and evaluates the current situation of rural medical and health supply efficiency from a number of perspectives,then analyzes the specific factors that affect the efficiency of supply.And in the end,make suggestions and relevant policies on the above basis.The research of rural medical and health service in supply efficiency involves medicine,health economics,econometrics,statistics,economics,management and other disciplines,and many area will benefit a lot from this research,such as the use of fiscal funds,the health care resource allocation,and the improve in existing financial resources so as to get better development of rural medical and health services.And from the perspective of the whole structural,China’s health expenditure ratio of GDP remained unchanged with the total cost of health has reached a certain level since 2003.And the government’s health costs accounted for the proportion of total health gradually increased when the personal health expenditure decline at the same time.But generally speaking,China governments’ financial investment in rural medical and health services is still in low level,and the diffidence a lot in various regions.In this case,the government pay much attention on the role that the rural health care investment really useful,especiallywhether to solve the farmers difficult to get treated,whether to improve the cure rate,whether to meet the need of majority farmers and satisfied them.Therefore,the objective evaluation of the current realities of health factors that affect the efficiency of the supply situation and sum up the problems that found in China’s rural health,not only make an accurate evaluate on the efficiency of the existing rural medical and health system,but also provide references for the future development of the relevant departments with important practical significances.In addition,through the measurement of the efficiency and related influencing factors of the rural medical and health services in the provinces and autonomous regions of our country,the rural medical and health services in each province are classified according to the efficiency and the level of the factors into the national level.So it’s convenient to make appropriate investment and improvement strategies with different conditions,and it’s also means a lot in practical,especially in the efficiency improvement of the use of financial funds and the development of primary health care.This paper uses qualitative analysis,so as to obtain more objective,truthful and reliable results fromdifferent level and perspective of the efficiency in health service delivery in rural area.This thesis divided into seven chapters.In the first chapter,it summarizes the article,puts forward the problems according to the research background,expounds the research significance,then puts forward the research methods,the main contents and the overall framework,and puts forward the innovation and shortcomings of this paper,so as to indicate the direction of this research.In second chapter,it makes a comparative analysis on the main theory of literature at home and abroad from the efficiency measurement methods of health care industry.Among them,it summarized the literature on the efficiency of foreign medical industry mainly from the government health expenditure scale efficiency,production efficiency and structure.And literature study of the domestic healthcare industry mainly from three aspects,from the connotation.the evaluation and the impact factors of efficiency.And,the domestic and foreign literatures are summarized into four aspects in the aspects of efficiency measurement method,the data envelopment analysis method,the stochastic boundary analysis method,the production function method and the subsidy dependency index method.At last,this paper makes a comparative analysis of the above literatures,and puts forward some questions and suggestions on the research contents,research methods and research perspectives of the existing literatures.In the third chapter,it analyzes the efficiency of rural medical service supply in China.At first,it defined the meaning of the efficiency of rural health services,and makes empirical analysison the service delivery efficiency of rural medical with the data of township hospitals in 29 provinces from 2003 to 2014.And selects the modified three-stage DEA model with the reasonability of data availability and rationale of efficiency measures,and uses the population mortality rate as the non-expected output,excluding per capita GDP,rural residents’ net income and other environmental factors and random error pairs that effect the rural health care supply efficiency in order to achieve a more realistic measure for supply efficiency.In the fourth chapter,this paper analysis the influencing factors of rural medical service supply efficiency in China.At first,it describes the impact of economic development and human capital on the efficiency of’rural health care supply.And analyzes economic development from the demand and supply of rural medical service.Then takes human capital from the relationship between population structure,population quality and population size,to the supply efficiency of rural medical service providers.Finally,uses relatively static dynamic analysis with the random effects model and the factors affecting the system GMM panel model for rural health service delivery efficiency,and concludes the following results.In the fifth chapter,it analysis the threshold level of the influencing factors of rural medical service supply efficiency in China.Firstly,the real factors that affect the efficiency of the supply efficiency is a nonlinear relationship,and then were per capita GDP,investment in rural health,rural health centers health workers accounted itself as a threshold value,discusses the relationships between those three variable supply and sanitation in rural areas of medical research,meanwhile measure the impact of medical service investment on supply efficiency based on four perspectives,such as the different perspectives of per capita GDP,the health workersproportion in township hospitals,the urbanization rate,and the new rural cooperative beneficiary with the threshold panel model.In the sixth chapter,it discusses the static analysis of rural public health supply efficiency in China.At first it summarizes the status of rural public health supply,then analysis the technical efficiency,pure technical efficiency and scale efficiency of rural public health supply by DEA model and principal component factors.And finally,draws a conclusion with the projection analysis of input and output indicators.In the seventh chapter.It makes a conclusions and policy recommendations,on the basis of summarizing the conclusion of the study,this paper puts forward some countermeasures and suggestions according to the current situation of rural medical and health supply and the implementation of the new rural cooperative medical policy.So,this paper makes four conclusions with the above research.Firstly,based on the three-stage DEA method considering expectation.In general,the change trend to the same from the annual mean value of the supply efficiency,and the adjusted efficiency value is improved.however,the overall rural medical service supply efficiency is not high,the provincial difference is obvious and needs to be further improved.Secondly,based on random effects model of static analysis,per capita GDP,rural health care investment,health and technical personnel ratio,total dependency ratio and new rural cooperative beneficiaries were positively correlated with rural medical service supply efficiency.Thirdly,analysesbased on the system GMM model of dynamic panel estimation.From the perspective of the dependent variable,it can be seen that the supply efficiency of the delayed one and two phases has a positive effect on the current supply efficiency.From the perspective of influencing factors,the current and lagged one of the role in promoting the proportion of health and technical personnel,new rural cooperative beneficiaries in the current and lagged period has a certain degree,the urbanization rate has a negative effect on the supply efficiency in the current period,but the lagged one has no effect.And the per capita GDP has a positive effect on the supply efficiency in the current period.but the effect of the lagged one is negative.Meanwhile,the educational level variables have negative effects in both current and delayed periods,and the effect of dependency is not significant in both current and delayed periods.Fourthly,analyses from the threshold panel regression.There is a single threshold for the efficiency of rural health investment and the supply efficiency of rural medical service.There are double thresholds in the efficiency of rural health investment and the supply efficiency of rural medical service.And under the perspective of per capita GDP,the proportion of health technology personnel,the urbanization rate perspective,the rural medical and health investment and rural health care supply efficiency there is a single threshold.But there is a double threshold between the rural health care investment and efficiency of rural medical service supply under new rural cooperative benefit perspective.This paper draws the following three conclusions through the study of supply efficiency in the rural public health.Firstly,in general,China’s rural public health supply efficiency still in low level,and the gap between the different provinces is huge.Secondly,the leading cause of invalid provinces DEA scale efficiency is low,public health resources supply structure is irrational,followed by technical efficiency is not high,that is,a lower level of resource utilization,failed to invest resources to maximize utilization.Thirdly,DEA invalid provinces can be divided into two categories:investment in three provinces of Tianjin,Shandong,Ningxia are achieved to maximum output due to pure technical efficiency,and 12 provinces are not 1 of scale efficiency and the remaining.Compared with the previous research,this paper may be get the innovation in the following three aspects.Firstly,takes an effective calculation of rural health service efficiency.The traditional three-stage DEA method is modified by the SBM model with non-expected output to make up for the defects of the traditional DEA model when the input is redundant or the output is insufficient,and the population mortality is treated,and the efficiency of the supply closer to the real calculation.Secondly,the dynamic and static comparative analysis of influencing factors on supply efficiency of rural medical service in China.The existing research is mainly based on the stationary effect model,but the research on dynamic analysis is less.On the basis of effectively measuring the efficiency of rural medical service supply,this paper also makes a dynamic and static comparative analysis of the factors that affect the efficiency,and fully considers the continuity and lag of the influence of real factors.Thirdly.using the threshold panel model,For the first time,shows the supply efficiency impact based on the per capita GDP,the proportion of health technical personnel in township hospitals,the ratio of urbanization,the beneficiaries of the new rural cooperative medical institutions,the efficiency of rural medical service supply and the visual effect of rural medical service investment.