Lobo M S C, Silva A C M, Lins M P E, Fiszman R
Serviço de Epidemiologia e Avaliação, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2009 Jun;43(3):437-45. Epub 2009 Apr 10.
To assess the impact of funding reform on the productivity of teaching hospitals.
Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: 'technical efficiency change,' or the relative variation of the efficiency of each unit; and 'technological change' after frontier shift.
There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication.
The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes.
评估资金改革对教学医院生产力的影响。
基于巴西联邦大学医院信息系统，采用线性规划技术的前沿方法、数据包络分析和投入导向可变规模报酬模型，对2003年和2006年的效率和生产力进行测量。计算Malmquist指数以检测研究期间的变化：“技术效率变化”，即各单位效率的相对变化；以及前沿移动后的“技术变化”。
教学医院平均预算增加了51%，技术效率得到提高（之前分别有11家、17家医院达到经验效率前沿），但技术前沿未出现同样情况。数据包络分析为每个低效单位（改革前后）设定了基准分数，技术效率与教学强度和专注度之间存在正相关。
改革促进了管理改进，但需要进一步跟踪以评估资金变化的有效性。
