基于数据包络分析模型和马尔可夫指数的安徽省县级公立医院效率与生产力研究。
Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China.
机构信息
Department of Research Administration Office (NNL); Department of Dean's Office, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.
Department of Health Services Management, School of Health Administration, Anhui Medical University, Hefei, Anhui 230032, China.
出版信息
Chin Med J (Engl). 2017 Dec 5;130(23):2836-2843. doi: 10.4103/0366-6999.219148.
BACKGROUND
China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis (DEA) model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development.
METHODS
We chose 12 country-level hospitals based on geographical distribution and the economic development level in Anhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions.
RESULTS
During 2010-2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was >1, and the rest are <1 between 2010 and 2015.
CONCLUSIONS
In 2010-2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.
背景
中国分别于 2009 年和 2012 年开始实施国家医疗卫生体制和公立医院改革。安徽省是四个试点省份之一，其医改措施受到全国广泛关注。上述改革的效果需要得到关注。本研究旨在基于数据包络分析（DEA）模型和安徽省的 Malmquist 指数，掌握县级公立医院的效率和生产力，为未来医院发展提供改进措施。
方法
我们选择了基于地理位置分布和安徽省经济发展水平的 12 家国家级医院。行政部门提供了从现场收集并整理的数据。使用 DEA 模型计算 12 家机构的动态效率和 Malmquist 指数因素。
结果
2010-2015 年，12 家县级公立医院的整体平均相对服务效率为 0.926，2010 年至 2015 年，每年有 4 家、6 家、7 家、7 家、6 家和 8 家医院达到 DEA 有效。在此期间，整体生产效率平均为 0.983，总生产力因素下降。2010-2015 年，有 5 家医院的整体生产效率大于 1，其余医院均小于 1。
结论
2010-2015 年，安徽省 12 家县级公立医院的相对服务效率呈下降趋势，各医院的服务效率发生变化。在过去的 6 年中，虽然一些医院是有效的，但安徽省县级公立医院的效率并没有显著提高，总要素生产率也没有得到有效提高。县级公立医院需要结合自身实际，找准自身不足。
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