目的 :探讨上海市中心城区与郊区社区卫生服务的效率及其特点。方法 :以2013年上海市50家申报创建全国示范社区卫生服务中心为研究对象,以柯布-道格拉斯生产函数为基础,通过计量经济学方法进行分析。结果 :建立了上海市中心城区和郊区社区卫生服务生产函数方程。结果显示:中心城区的社区卫生服务经济规模呈报酬递减的特征而郊区社区卫生服务中心的社区卫生服务经济规模呈报酬不变的特征。结论 :人力资源的投入对社区卫生服务的产出作用大于资金投入的作用,人力资源是促进上海市社区卫生服务发展的主要因素;人力建设对郊区社区卫生服务的提高更为关键;由于中心城区和郊区的规模经济不同提示了卫生行政部门对社区卫生服务的发展策略也应不同,中心城区更要重视社区卫生服务的效率提高,创新服务模式。
Objective: To explore the efficiency of community health service between urban and rural areas of Shanghai and its characteristics. Methods: Fifty community health centers in Shanghai that had applied to create "National Demonstration Community Health Center" in 2013 were selected as the research objects. Based on Cobb- Douglas production function, their functions were analyzed by the methods of econometrics. Results: Two production functions were formulated for urban and rural areas. The results showed that characteristics of the economic scales of the community health service centers in urban areas were in diminishing returns, while the rural ones in the constant returns. Conclusion: The output role of increasing human resource investment for the community health service is greater than that of fund investment. Human resources are the major factors in promoting the development of community health services in Shanghai. Human capacity building is more critical to improve the community health services. Due to the differences of economic scales between urban and rural areas, it suggests that the health administrative department should make the policy different for their community health services. Those community health centers in urban areas should pay more attention to the service efficiency and service innovation.