Research On The Operational Efficiency And Influencing Factors Of Hierarchical Diagnosis And Treatment

Since the founding of the Party for a hundred years,the Chinese government has always attached great importance to health care as a livelihood issue.To change the structural contradictions in the medical and health field,General Secretary Xi Jinping proposed the establishment of a new pattern of hierarchical diagnosis and treatment to provide all-round full-cycle health services for the people.The smooth progress of hierarchical diagnosis and treatment is based on the scientific and reasonable allocation of medical resources.As the bottom of the medical and health system,the grass-roots medical and health institutions are of great significance to the development of the entire medical service system.The first diagnosis rate at the grassroots level is the key to improve the quality and efficiency of hierarchical diagnosis and treatment.With the continuous promotion of hierarchical diagnosis and treatment and the continuous improvement of the service capacity of primary medical institutions,it is worth our attention and attention to clarify the overall input-output efficiency of hierarchical diagnosis and treatment in China and explore the external environmental factors that affect the efficiency of hierarchical diagnosis and treatment.This study first defines the concepts and theories related to hierarchical diagnosis and treatment,then analyzes the operation status of hierarchical diagnosis and treatment,combs the development context of policies related to hierarchical diagnosis and treatment and specific construction measures,and selects the data from 2012 to2019,and uses the quantitative statistical analysis method to analyze the allocation of medical resources during the operation of hierarchical diagnosis and treatment.Furthermore,further explore whether the medical resources invested by the state have been effectively utilized.Based on the panel data of 31 provinces in China from 2012 to 2019,from the perspective of input-output,apply the super-efficiency SBMMalmquist model to evaluate the operational efficiency of hierarchical diagnosis and treatment in various provinces and cities.Finally,taking super-efficiency as the dependent variable,based on Andersen model as the theoretical framework,and using Tobit model,we further analyze the factors that affect the operation efficiency of hierarchical diagnosis and treatment from three aspects: tendency characteristics,enabling resources and demand factors.Research found that since the construction of hierarchical diagnosis and treatment,the relevant policies and measures have been gradually improved,and the country has increased its investment in health care,especially the number of primary medical and health institutions and the number of beds have been growing slowly,the number of health technicians has been greatly improved,and the burden of personal medical expenses has been slightly reduced,which shows that the unreasonable situation of medical resource allocation in China is gradually improving.The overall operating efficiency of each province and city is good,showing a fluctuating upward trend,but there is a difference,showing a decreasing pattern in the eastern,western,central and northeastern regions;The slight decline of total factor productivity is mainly due to the restriction of technological progress,and the change of technological efficiency has a certain promoting effect on its development,in which the change of scale efficiency value is almost consistent with the change of technological efficiency value,while the change of pure technological efficiency value is relatively slow,and the impact on the level of technological efficiency is not obvious.Among the influencing factors that urbanization rate and operation efficiency have a significant negative effect,while population size,aging degree,residents’ income level and population health level have a significant positive effect on efficiency.Therefore,suggested that we should strengthen the support of talents and break through the technical bottleneck of grass-roots diagnosis and treatment;Innovate the management system and energize the primary medical care;Create a unique brand of primary medical care and provide policy recommendations for fullchain medical services to further promote the construction of the hierarchical diagnosis and treatment system for the government,and reasonably guide the people to divert to the grass-roots level.