Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Jun 18;49(3):483-488.
To assess and analyze the operation efficiency of 8 commission general public hospitals managed directly by National Health and Family Planning Commission and 8 municipal general hospitals managed directly by Beijing Municipal Administration of Hospitals in Beijing and to provide suggestions on improving service capacity and designing relevant health policy.
Input and output data of 8 commission hospitals and 8 municipal hospitals were obtained from Beijing Direct-Reported Health Statistics data from 2011 to 2014. Data envelopment analysis was used as the hospital operation efficiency measurement tool. The CCR and BCC models were built to calculate technical efficiency (TE), pure technical efficiency (PTE), scale efficiency (SE) and the status of scale efficiency of 16 hospitals in 2011 and 2014; the Malmquist index model was built to analyze the total factor productivity change (TFPC), technological change (TC), technical efficiency change, pure technical efficiency change and scale efficiency change of the 16 hospitals from 2011 to 2014.
In 2011, the TE, PTE and SE of the commission hospitals were higher than those of the municipal hospitals, and the TEs of the commission hospitals and the municipal hospitals were 0.918 and 0.873 respectively. In 2014, the TE, PTE and SE of commission hospitals were lower than those of the municipal hospitals, and the TE of the commission hospitals and the municipal hospitals were 0.906 and 0.951, respectively, which was contrary to the results in 2011. According to the Malmquist index model, the average of TFPC of the municipal hospitals was larger than that of the commission hospitals, the former increased 5.9% and the latter increased 2.8% per year; the average of TC was greater than the one in both the municipal hospitals and the commission hospitals, with a growth of 3.2% and 2.9% per year, respectively; the average growth of PTE in the commission hospitals was lower than that of the municipal hospitals, and the average descent of SE in the commission hospitals was larger than that in the municipal hospitals.
There are significant differences in the operation efficiency between different management systems and the main factors associated with operation efficiency are the technological and management level. Given scale efficiency status and macroeconomic medical policies, the commission hospitals and the municipal hospitals require further adjusting the distribution of medical resources, and it is of great significance for all the commission hospitals and the municipal hospitals to improve the management level and resource integration capability.
评估与分析国家卫生和计划生育委员会直属的8家委管公立医院以及北京市医院管理局直属的8家市属公立医院的运行效率，并为提高服务能力及制定相关卫生政策提供建议。
获取2011年至2014年北京市直报卫生统计数据中8家委管医院和8家市属医院的投入与产出数据。采用数据包络分析作为医院运行效率测量工具。构建CCR和BCC模型，计算2011年和2014年16家医院的技术效率（TE）、纯技术效率（PTE）、规模效率（SE）以及规模效率状况；构建Malmquist指数模型，分析2011年至2014年16家医院的全要素生产率变化（TFPC）、技术变化（TC）、技术效率变化、纯技术效率变化和规模效率变化。
2011年，委管医院的TE、PTE和SE高于市属医院，委管医院和市属医院的TE分别为0.918和0.873。2014年，委管医院的TE、PTE和SE低于市属医院，委管医院和市属医院的TE分别为0.906和0.951，与2011年结果相反。根据Malmquist指数模型，市属医院的TFPC平均值大于委管医院，前者每年增长5.9%，后者每年增长2.8%；TC平均值大于市属医院和委管医院，分别每年增长3.2%和2.9%；委管医院PTE的平均增长低于市属医院，委管医院SE的平均下降幅度大于市属医院。
不同管理体制下医院运行效率存在显著差异，与运行效率相关的主要因素是技术和管理水平。鉴于规模效率状况及宏观经济医疗政策，委管医院和市属医院均需进一步调整医疗资源配置，提高管理水平和资源整合能力对所有委管医院和市属医院具有重要意义。
