Jing R Z, Zhang H Y, Xu T T, Zhang L Y, Fang H
Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China; China Center for Health Development Studies, Peking University, Beijing 100191, China.
China Center for Health Development Studies, Peking University, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Jun 18;50(3):408-415.
To evaluate the comprehensive technical efficiency of the tertiary public hospitals in Beijing between 2006 and 2015 and explore its influencing factors, so as to propose corresponding policy suggestions.
The data envelopment analysis was employed to evaluate the comprehensive technical efficiency, pure technical efficiency and scale efficiency of the tertiary public hospitals in Beijing. Malmquist index model was used to analyze the changes of the above three dynamic efficiencies. Finally, randomeffect panel tobit model was utilized to analyze the influencing factors of the comprehensive technical efficiency.
The average comprehensive technical efficiency and pure technical efficiency of the tertiary public hospitals in Beijing were relatively high, and they had respectively increased from 0.44 and 0.51 in 2006 to 0.62 and 0.68 in 2015, and the highest proportion of two kinds of efficiency values was between 0.5 and 0.8. Most of the scale efficiency values distributed between 0.8 and 1.0, and the majority of hospitals were in a state of decreasing returns to scale. The total factor productivity of hospitals had been increasing at an average rate of 5.78% per year due to the double progress of technical efficiency and technology at annual rates of 3.77% and 1.94% respectively, further decomposing technological efficiency change, and the pure technical efficiency change increased at the speed of 3.21% per year, and the annual average rate of progress in scale efficiency was only 0.53%. The comprehensive technical efficiency was positively correlated with the turnover rate of beds, annual visits per doctor, the ratio of doctors to nurses, and negatively correlated with the number of beds, the ratio of outpatients to inpatients, the proportion of medical technical personnel, and the proportion of drugs.
Future health policies should strictly control the scale of tertiary public hospitals, pay attention to the innovation and application of hospital technology, change the hospital internal management level and management model, promote refined management, and achieve sustainable development.
评价2006—2015年北京市三级公立医院综合技术效率并探讨其影响因素，提出相应政策建议。
采用数据包络分析法评价北京市三级公立医院综合技术效率、纯技术效率和规模效率；运用Malmquist指数模型分析上述3种动态效率变化情况；最后采用随机效应面板tobit模型分析综合技术效率的影响因素。
北京市三级公立医院综合技术效率和纯技术效率均值较高，分别从2006年的0.44和0.51提高到2015年的0.62和0.68，两种效率值占比最高的区间为0.5～0.8。多数规模效率值分布在0.8～1.0之间，多数医院处于规模报酬递减状态。医院全要素生产率因技术效率和技术进步分别以年均3.77%和1.94%的速度双重进步，年均增长5.78%，进一步分解技术效率变化，纯技术效率变化以年均3.21%的速度增长，规模效率年均进步率仅为0.53%。综合技术效率与病床周转率、医生年门诊量、医护比呈正相关，与床位数、门诊住院比、医技人员占比、药品占比呈负相关。
未来卫生政策应严格控制三级公立医院规模，注重医院技术创新与应用，转变医院内部管理水平和管理模式，推进精细化管理，实现可持续发展。
