[目的] 考察健康扶贫背景下云南省20个少数民族自治县医院资源配置效率状况,分析少数民族聚集地区卫生事业存在的问题,为有效贯彻《云南省健康扶贫30条措施》提供参考。[方法] 应用Malmquist指数及数据包络法规模报酬可变模型(DEA-BC²模型)计算2008-2014年少数民族自治县医院资源配置全要素生产率、综合效率。在此基础上对综合效率相对无效的决策单元投入、产出值进行投影分析,并对卫生资源进行优化;之后,从政府层面和医院管理层面提出建议。[结果] 2008-2014年,只有8个自治县的医院配置全要素生产率处于上升态势,其余各自治县均处于下降趋势;大部分各自治县域医院配置效率均处于相对无效的状态,且主要是由于规模效率无效所致。相对无效的自治县均存在每千人医院数冗余的情况,在产出不足方面,各自治县有所差异。[结论] 云南少数民族自治县县医院配置效率总体水平不高,且各自治县配置效率水平相差较大。

Objective To investigate hospital resource allocation efficiency in 20 minority autonomous counties of Yunnan province under the background of healthy poverty alleviation,analyze the problems existing in health services in areas where ethnic minority gather so as to provide reference for effectively carrying out “Thirty items measures of Yunnan Healthy Poverty Alleviation”. Methods This study used Malmquist index and DEA-BC2 model to calculate total factor productivity and combined efficiency of hospital resource allocation in minority autonomous counties from 2008 to 2014. On this basis,we performed projection analysis of input and output values of the decision making unit which combined efficiency was relatively ineffective,and optimized health resource. Then it proposed suggestions in governmental level and hospital level. Results From 2008 to 2014,the total factor productivity of hospitals in 8 autonomous counties was on the rise trend,and the rest were in downward trend. Most of the county hospitals' allocation efficiency was relatively ineffective,mainly due to the inefficiency of scale efficiency. In terms of input,there were redundant hospitals per thousand people in relatively ineffective autonomous counties. In terms of insufficient output,there were differences in autonomous counties. Conclusions The overall level of hospitals allocation efficiency of in Yunnan minority autonomous counties is not high,and the allocation efficiency level has large difference in autonomous counties.