测量中国湖北省二级妇幼保健院的技术效率和生产力：来自 2019 至 2021 年湖北省的一些证据。

Measuring Technical Efficiency and Productivity of Secondary Maternal and Child Health Hospitals in Hubei, China: Some Evidences from Hubei Province of China 2019 to 2021.

机构信息

Wuhan University, Wuhan, Hubei, P.R. China.

Huazhong University of Science and Technology, Wuhan, P.R. China.

出版信息

Inquiry. 2024 Jan-Dec;61:469580241254543. doi: 10.1177/00469580241254543.

DOI:10.1177/00469580241254543

PMID:38814014

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11143800/

Abstract

Environmental factors like COVID-19 can have significant impact on technical efficiency (TE) and total factor productivity (TFP) of health services provided. In this study, focusing on Maternal and Child Health (MCH) hospitals in Hubei Province of China in 2019 to 2021, we aimed to measure their TE and TFP, identify some influential environmental factors, and propose some policy recommendations. Altogether 62 secondary MCH hospitals were selected as the study sample. Four input indicators, 3 output indicators, and 4 environmental indicators were selected to analyze the panel data from 2019 to 2021. Three-stage Data Envelopment Analysis (DEA) and Malmquist Productivity Index (MPI) model were employed to estimate the TE and TFP of these hospitals. During 2019 to 2021, the inputs of the sample hospitals had increased, while the outputs had decreased. The inputs redundancy was negatively associated with birth rate, number of residents, and GDP per capita ( < .05). It was positively associated with number of COVID-19 infections ( < .05). The adjusted TE scores in 2019 to 2021 were 0.822, 0.784, and 0.803, respectively. The TFP declined in 2020 and 2021 compared to 2019, with scores being 0.845 and 0.762. The technical efficiency change (TEC) scores from 2019 to 2021 were 0.926 and 1.063. The technological change (TC) scores from 2019 to 2021 were 0.912 and 0.716. During 2019 to 2021, the operation of sample hospitals had been significantly influenced by environmental factors like COVID-19 pandemic, low birth rate, number of residents, and GDP per capita. The inputs had increased but outputs had decreased, leading to an increase in inputs redundancy and a decline in TE. The TFP showed a downward trend, with TC and SEC being the priority directions for improvement. Some recommendations are made for both hospitals and government to continuously improve the TE and TFP.

摘要

环境因素，如新冠疫情，对卫生服务的技术效率（TE）和全要素生产率（TFP）有显著影响。本研究聚焦于中国湖北省的妇幼保健院，研究时间为 2019 年至 2021 年，旨在测量它们的 TE 和 TFP，识别一些有影响的环境因素，并提出一些政策建议。共选取 62 家二级妇幼保健院作为研究样本。选取了四个投入指标、三个产出指标和四个环境指标，对 2019 年至 2021 年的面板数据进行分析。采用三阶段数据包络分析（DEA）和 Malmquist 生产力指数（MPI）模型来估计这些医院的 TE 和 TFP。2019 年至 2021 年期间，样本医院的投入增加，产出减少。投入冗余与出生率、居民人数和人均 GDP 呈负相关（<0.05），与新冠感染人数呈正相关（<0.05）。2019 年至 2021 年调整后的 TE 评分分别为 0.822、0.784 和 0.803。与 2019 年相比，2020 年和 2021 年 TFP 下降，评分分别为 0.845 和 0.762。2019 年至 2021 年技术效率变化（TEC）评分分别为 0.926 和 1.063。2019 年至 2021 年技术变化（TC）评分分别为 0.912 和 0.716。2019 年至 2021 年，样本医院的运营受到新冠疫情、低出生率、居民人数和人均 GDP 等环境因素的显著影响。投入增加但产出减少，导致投入冗余增加和 TE 下降。TFP 呈下降趋势，TC 和 SEC 是改进的优先方向。针对医院和政府提出了一些建议，以持续提高 TE 和 TFP。