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松弛资源对三级和二级医院医疗成本的影响:2015 年至 2019 年北京市公立医院的面板数据研究。

Impact of slack resources on healthcare costs in tertiary and secondary hospitals: a panel data study of public hospitals in Beijing from 2015 to 2019.

机构信息

School of Public Health, Capital Medical University, Beijing, China.

Research Center for Capital Health Management and Policy, Beijing, China.

出版信息

BMJ Open. 2023 Apr 19;13(4):e068383. doi: 10.1136/bmjopen-2022-068383.

Abstract

OBJECTIVE

This study aims to explore the relationship between slack resources and cost consumption index in tertiary and secondary hospitals and to provide targeted healthcare resource utilisation recommendations for tertiary and secondary hospital managers.

DESIGN

This is a panel data study of 51 public hospitals in Beijing from 2015 to 2019.

SETTING

Tertiary and secondary public hospitals in Beijing. Data envelope analysis was used to calculate the slack resources. Regression models were used to explore the relationship between slack resources and healthcare costs.

PARTICIPANTS

A total of 255 observations were collected from 33 tertiary hospitals and 18 secondary hospitals.

OUTCOME MEASURES

Slack resources and healthcare costs in tertiary and secondary public hospitals in Beijing from 2015 to 2019. Linear or curve relationship between slack resources and healthcare costs in tertiary and secondary hospitals.

RESULTS

The cost of healthcare in tertiary hospitals has always been higher than in secondary hospitals, and the slack resources in secondary hospitals have always been worse than in tertiary hospitals. For tertiary hospitals, the cubic coefficient of slack resources is significant (β=-12.914, p<0.01) and the R of cubic regression is increased compared with linear and quadratic regression models, so there is a transposed S-shaped relationship between slack resources and cost consumption index. For secondary hospitals, only the first-order coefficient of slack resources in the linear regression was significant (β=0.179, p<0.05), so slack resources in secondary hospitals were positively related to the cost consumption index.

CONCLUSIONS

This study shows that slack resources' impact on healthcare costs differs in tertiary and secondary public hospitals. For tertiary hospitals, slack should be kept within a reasonable range to control excessive growth in healthcare costs. In secondary hospitals, keeping too many slack resources is not ideal, so managers should adopt strategies to improve competitiveness and service transformation.

摘要

目的

本研究旨在探讨三级和二级医院松弛资源与成本消耗指数之间的关系,为三级和二级医院管理者提供有针对性的医疗资源利用建议。

设计

这是一项 2015 年至 2019 年期间对北京 51 家公立医院的面板数据研究。

地点

北京的三级和二级公立医院。使用数据包络分析来计算松弛资源。使用回归模型来探索松弛资源与医疗成本之间的关系。

参与者

共收集了 33 家三级医院和 18 家二级医院的 255 个观测值。

结果

北京三级和二级公立医院 2015 年至 2019 年的松弛资源和医疗成本。三级和二级医院松弛资源与医疗成本之间的线性或曲线关系。

结论

三级医院的医疗成本一直高于二级医院,二级医院的松弛资源一直比三级医院差。对于三级医院,松弛资源的三次方系数是显著的(β=-12.914,p<0.01),三次回归的 R 与线性和二次回归模型相比有所增加,因此松弛资源与成本消耗指数之间存在一种反向 S 形关系。对于二级医院,只有线性回归中松弛资源的一阶系数是显著的(β=0.179,p<0.05),因此二级医院的松弛资源与成本消耗指数呈正相关。

本研究表明,松弛资源对三级和二级公立医院医疗成本的影响不同。对于三级医院,应将松弛资源保持在合理范围内,以控制医疗成本的过度增长。在二级医院,保持过多的松弛资源并不理想,因此管理者应采取策略提高竞争力和服务转型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb1/10124247/80f8c4ba7df7/bmjopen-2022-068383f01.jpg

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