State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
School of Economics, Xiamen University, Xiamen, China.
Front Public Health. 2023 Mar 2;11:1066190. doi: 10.3389/fpubh.2023.1066190. eCollection 2023.
Care services provided by long-term care facilities (LTCFs) are currently plagued by care resource shortages and insufficient utilization. The analysis on the temporal and spatial distribution of human resources and non-human resources in LTCFs, could provide a basis to optimize resource allocation and efficient use of limited resources.
This study used data envelopment analysis to comprehensively evaluate the efficiency of human and non-human resources in different time spans and regions. The spatial Markov chain and spatial correlation were also applied to explore the heterogeneity of and correlation between the service efficiency of LTCFs in different regions and then analyzes the influencing factors of efficiency using Tobit regression model.
The quantitative changes in the service efficiency of LTCFs in various provinces showed a "W" shape in two periods, ranging from 0.8 to 1.6. The overall efficiency of LTCFs in different regions had a lower probability to achieve short-term cross-stage development. Non-human resource efficiency presented a "cluster" distribution mode, demonstrating a great probability to achieve cross-stage development, which might be due to the regional disparities of economic development and land resource. Tobit regression analysis results also showed that the comprehensive efficiency of LTCFs decreases by 0.210 for every square increase in construction space variation. However, human resource efficiency had a significant spatial polarization, making it difficult to develop area linkages. The reason for this might be the nursing staff have relatively stable regional characteristics, weakening the inter-provincial spatial connection. We also found that female workers, aged between 35 and 45 can positively affect the efficiency of LTCFs. Those staff stay focused and improve their skills, which might improve the efficiency of LTCFs. So improving technology and service quality changes by increasing female workers, aged between 35 and 45, and avoiding excessive construction space changes can enhance the growth of service quality and personnel stability of LTCFs.
There is an urgent trade-off among staff quality improvement, resource reduction, construction excessive and substantial regional variation in efficiency. Therefore, strengthening policy support to encourage inter-regional initiatives, particularly highlighting the development of human resources interaction and common development is urgent.
长期护理机构（LTCF）提供的护理服务目前面临着护理资源短缺和利用不足的问题。分析 LTCF 中人力资源和非人力资源的时空分布，可以为优化资源配置和有效利用有限资源提供依据。
本研究采用数据包络分析（DEA）方法综合评价不同时间跨度和地区的人力资源和非人力资源效率。还应用空间马尔可夫链和空间相关性来探索不同地区 LTCF 服务效率的异质性和相关性，然后使用 Tobit 回归模型分析效率的影响因素。
各省份 LTCF 服务效率的量化变化在两个时期内呈“W”形，范围在 0.8 到 1.6 之间。不同地区 LTCF 的整体效率在短期内实现跨阶段发展的可能性较低。非人力资源效率呈现“集聚”分布模式，实现跨阶段发展的可能性较大，这可能是由于经济发展和土地资源的区域差异所致。Tobit 回归分析结果还表明，每增加一个平方单位的建筑面积变化，LTCF 的综合效率就会下降 0.210。然而，人力资源效率存在显著的空间极化，难以实现区域间的联系。造成这种情况的原因可能是护理人员具有相对稳定的区域特征，削弱了省际空间联系。我们还发现，女性员工（年龄在 35 岁至 45 岁之间）可以积极影响 LTCF 的效率。这些员工专注并提高技能，这可能会提高 LTCF 的效率。因此，通过增加女性员工（年龄在 35 岁至 45 岁之间）并避免过度的建筑面积变化，可以提高服务质量的增长和 LTCF 的人员稳定性，从而改善技术和服务质量。
在员工素质提高、资源减少、建设过度和效率实质性区域差异之间存在紧迫的权衡取舍。因此，加强政策支持，鼓励区域间的合作，特别是突出人力资源互动和共同发展的发展，是当务之急。
