随着人民群众对健康需求的加剧、国家健康政策的具体实施和卫生健康事业的逐步深入，医疗服务作为人民群众和政府所关注的一项重要民生健康工作，已逐步肩负公共服务的一项重要使命，然而在医疗服务过程中出现的专业性不强、技术水平不高、服务态度不好和城乡差距大等问题，成为了亟待解决的问题短板。医疗服务效率评价是医疗服务重要的控制手段。因此，评价医疗机构医疗服务效率水平和影响因素，对进一步改善医疗服务、改进医疗服务流程、创新方便人民群众看病就医和提高医疗服务效率至关重要，提高医疗服务效率对推动健康中国战略、促进卫生健康事业稳定发展具有正向的推动作用，让更多群众得以享受到全周期健康服务。

本文采用实证分析方法以新疆H县医疗机构为例，系统全面回顾梳理相关研究文献，在分析地域性特征和专家访谈咨询的基础上，结合H县地域特征和政策背景，构建了新疆H县医疗机构医疗服务效率评价体系，引入了针对性的医疗服务效率评价模型DEA-BBC、CCR、Malmquist（数据包络分析）三个模型，解决了医疗机构规模、地域等异质性的问题。根据H县2007-2021年医疗机构客观医疗数据，对医疗机构综合效率、纯技术效率、规模报酬、全要素生产率等医疗服务效率进行了测算，针对DEA有效、弱有效、无效年度医疗机构医疗服务效率进行了进一步测算，并对测算结果进行了具体原因分析，同时，根据H县2007-2021年医疗机构投入和产出原始面板数据，对医疗机构医疗服务进行了Malmquist指数测算，并对纯技术效率变化指数、医疗服务技术效率变化指数、全要素生产率指数、技术进步指数、规模效率变化指数等结果进行了分析，得出影响H县医疗服务全要素生产率变化的主要因素。针对测算结果、原因分析和影响因素分析，进行了投影分析，得到医疗机构2017-2021年5年每个年份的投入量和产出量的改进值，并针对每个医疗机构提出了具体的改进措施。最后，根据H县卫生事业发展现状以及研究结果，提出了相关的政策建议。

研究显示，新疆H县15个年度医疗服务平均综合效率为0.887，平均纯技术效率为0.924，平均规模效率为0.958，11个年度规模报酬递减，4个年度医疗服务效率DEA有效，4个DEA有效年度中医疗机构医疗服务效率DEA有效的占38.9%；在DEA有效年度医疗机构1、医疗机构2平均综合效率最小分别为0.46、0.30远小于1，规模报酬呈现递减。在DEA弱有效的2个年度平均综合效率为0.935，医疗机构2平均综合效率为0.414最低，其规模报酬递减最严重。在DEA无效的9个年度的平均综合效率为0.826，医疗机构2的平均综合效率为0.565远低于平均综合效率；Malmquist指数平均值为0.9，全要素生产率年均降低10%，技术进步指数平均值为0.876，纯技术效率平均值为1.038，规模效率变化指数平均值为0.995。H县医疗卫生行业发展趋于稳定，但仍有提升空间。

结果表明，一是以县级医疗机构作为样本进行医疗服务效率评价，不仅要考虑医疗卫生资源分布，也要考虑地域性特征，在指标体系构建上，要综合考虑影响性较大的投入产出指标，选择能够规避异质性的模型进行医疗服务效率评价。样本数量上，要尽量大，数据量大，能够将现实状况更凸显。在模型构建上，根据地域性、人口、卫生资源的不同情况，要确定投入导向或者产出导向。二是H县医疗机构医疗服务效率低下的主要影响是纯技术效率和规模报酬，技术进步指数变化是影响H县全要素生产率变化的主要因素，其中，农牧区效率高于城区，城区掌握的技术优于非城区，所有医疗机构医疗服务效率逐步在稳定，医疗服务效率并未受到治安值班等其他行政工作影响，在农牧区反而促进了医疗服务效率的提高。三是针对H县医疗机构存在投入冗余、产出不足的问题，可以通过改善管理、改进措施，提高资源配置、提高总诊疗人次和病床使用量等具体改进措施进行综合干预。四是为提升H县医疗机构医疗服务，建议措施如下：1.强化医疗卫生服务监督工作；2.保障医联体建设与分级诊疗工作真正落到实处；3.完善县域内城乡医疗卫生资源配置；4.强化医疗卫生人才队伍建设；5.支持医疗卫生服务创新。

With the increasing demand for health among the people，the specific implementation of national health policies， and the gradual deepening of the health industry，medical services， as an important livelihood and health work of concern to the people and the government，have gradually shouldered an important mission of public services. However，in the process of medical services， there are problems such as weak professionalism， low technical level， poor service attitude，and large urban-rural gap，It has become an urgent problem to solve. The evaluation of medical service efficiency is an important control measure for medical services. Therefore， evaluating the efficiency level and influencing factors of medical services in medical institutions is crucial for further improving medical services，improving medical service processes， innovating and facilitating medical treatment for the people， and improving medical service efficiency. Improving medical service efficiency plays a positive role in promoting the healthy China strategy and promoting the stable development of the health industry， allowing more people to enjoy full cycle health services.

This article uses empirical analysis methods to comprehensively review and sort out relevant research literature on medical institutions in H County， Xinjiang. Based on the analysis of regional characteristics and expert interviews，combined with the regional characteristics and policy background of H County，a medical service efficiency evaluation system for medical institutions in H County，Xinjiang is constructed. Three targeted medical service efficiency evaluation models，DEA-BBC，CCR，and Malmquist (Data Envelopment Analysis)，are introduced，Solved the problem of heterogeneity in the scale and geography of medical institutions. Based on the objective medical data of medical institutions in H County from 2007 to 2021， the comprehensive efficiency， pure technical efficiency， return to scale， total factor productivity，and other medical service efficiency of medical institutions were calculated. Further calculations were conducted on the medical service efficiency of medical institutions in DEA effective，weak effective，and ineffective years，and the specific reasons for the calculation results were analyzed. At the same time， based on the original panel data of medical institution input and output in H County from 2007 to 2021，We conducted Malmquist index calculations on numerous medical services provided by medical institutions， and analyzed the results of pure technical efficiency change index，medical service technical efficiency change index，total factor productivity index，technological progress index，and scale efficiency change index. We identified the main factors affecting the total factor productivity change of medical services in H County. Projection analysis was conducted on the calculation results，cause analysis，and influencing factor analysis to obtain the improvement values of the input and output of medical institutions for each year from 2017 to 2021. Specific improvement measures were proposed for each medical institution. Finally，based on the current development status and research results of the health industry in H County，relevant policy recommendations were proposed.

Research shows that the average comprehensive efficiency of medical services in H County， Xinjiang in 15 years is 0.887，the average pure technical efficiency is 0.924，and the average scale efficiency is 0.958. The return on scale decreases in 11 years，and the DEA of medical service efficiency in 4 years is effective. The DEA of medical service efficiency in traditional Chinese medicine institutions in 4 years is effective，accounting for 38.9% of the total； In the DEA effective year， the average comprehensive efficiency of medical institution 1 and medical institution 2 is 0.46 and 0.30，respectively，which are far less than 1，showing a decreasing return to scale. The average comprehensive efficiency in the two weakly effective years of DEA is 0.935，while the average comprehensive efficiency in medical institution 2 is the lowest at 0.414， with the most severe decline in returns to scale. The average comprehensive efficiency in the nine years when DEA was ineffective was 0.826，while the average comprehensive efficiency in Medical Institution 2 was 0.565，which was much lower than the average comprehensive efficiency； The average value of the Malmquist index is 0.9，the average annual decrease in total factor productivity is 10%， the average value of the technological progress index is 0.876，the average value of pure technological efficiency is 1.038，and the average value of the scale efficiency change index is 0.995.The development of the medical and health industry in H County has become stable，but there is still room for improvement.

The results indicate that，firstly，using county-level medical institutions as samples for medical service efficiency evaluation，not only the distribution of medical and health resources but also regional characteristics should be considered. In the construction of the indicator system， it is necessary to comprehensively consider input-output indicators with significant impact，and select a model that can avoid heterogeneity for medical service efficiency evaluation. In terms of sample size，try to be as large as possible，with a large amount of data that can highlight the actual situation. In terms of model construction，input orientation or output orientation should be determined based on different regions，populations，and health resources. The second is that the main impact of the low efficiency of medical services in H County's medical institutions is pure technical efficiency and returns to scale. The change in the technological progress index is the main factor affecting the change in total factor productivity in H County. Among them，the efficiency of agricultural and pastoral areas is higher than that of urban areas，and the technology mastered by urban areas is better than that of non urban areas. The efficiency of medical services in all medical institutions is gradually stabilizing，and the efficiency of medical services is not affected by other administrative work such as public security duty，In agricultural and pastoral areas，it has actually promoted the improvement of the comprehensive efficiency of medical services. Thirdly，in response to the problems of redundant investment and insufficient output in medical institutions in H County，comprehensive interventions can be implemented through specific improvement measures such as improving management and measures，increasing resource allocation，increasing total diagnosis and treatment visits，and increasing bed usage. Fourthly，in order to improve the medical services of medical institutions in H County，the recommended measures are as follows: 1. Strengthen the supervision of medical and health services； 2. Ensure that the construction of medical consortia and graded diagnosis and treatment work are truly implemented； 3. Improve the allocation of medical and health resources in urban and rural areas within the county； 4. Strengthen the construction of medical and health talent teams； 5. Support innovation in healthcare services.