Jian Wei-yan, Tang Shu-nv, Hu Mu
Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Jun 18;43(3):403-6.
To analyze the relationship between scale and outputs of inpatient services of public general hospitals.
Data on hospital scales and outputs were drawn from Beijing Health Statistics Annuals and the Database of Inpatient Record administered by Beijing Health Bureau. The outputs of inpatient services were measured, risk-adjusted by Beijing Diagnosis Related Groups (BJ-DRGs). Based on the Cobb-Douglas production function, regression analysis was used to evaluate the contribution of manpower and material resources to the changes in outputs of hospitals on different scales, respectively.
Public general hospitals with 200-800 beds were at the stage of economical scale. In the 200-500-bed hospitals, investment of both human and material resources contributed to output changes. In the 501-800-bed hospitals, output changes were positively correlated with manpower input, but not with material resources.
In the specific environment in Beijing, medium-sized hospitals are appropriate when the government plan to build hospitals mainly focused on inpatient services. The larger the scale of hospitals is, the more important is the manpower imput. The personnel system reform for public hospitals is urgent.
分析公立综合医院住院服务规模与产出之间的关系。
医院规模和产出数据取自《北京卫生统计年鉴》以及北京市卫生局管理的住院病历数据库。住院服务产出采用北京疾病诊断相关分组(BJ-DRGs)进行测量并进行风险调整。基于柯布-道格拉斯生产函数,分别采用回归分析评估不同规模医院人力和物力资源对产出变化的贡献。
200-800张床位的公立综合医院处于经济规模阶段。在200-500张床位的医院中,人力和物力资源投入均对产出变化有贡献。在501-800张床位的医院中,产出变化与人力投入呈正相关,但与物力资源无关。
在北京的特定环境下,政府规划建设以住院服务为主的医院时,中型医院较为适宜。医院规模越大,人力投入越重要。公立医院人事制度改革刻不容缓。