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中国罗湖医疗改革后紧密型医联体内部的卫生资源配置:效率、生产力和影响因素。

Health resource allocation within the close-knit medical consortium after the Luohu healthcare reform in China: efficiency, productivity, and influencing factors.

机构信息

Department of Hospital Group Office, Shenzhen Luohu Hospital Group Luohu People's Hospital, (The Third Affiliated Hospital of Shenzhen University), Shenzhen, China.

Institute of Medical Information, Center for Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Front Public Health. 2024 Aug 29;12:1395633. doi: 10.3389/fpubh.2024.1395633. eCollection 2024.

Abstract

OBJECTIVE

This study aims to assess the efficiency and productivity of the Luohu Hospital Group after the reform and to identify factors influencing the efficiency to support the future development of medical consortia.

METHODS

Data on health resources from Shenzhen and the Luohu Hospital Group for the years 2015 to 2021 were analyzed using the super-efficiency slack-based measure data envelopment analysis (SE-SBM-DEA) model, Malmquist productivity index (MPI), and Tobit regression to evaluate changes in efficiency and productivity and to identify determinants of efficiency post-reform.

RESULTS

After the reform, the efficiency of health resource allocation within the Luohu Hospital Group improved by 33.87%. Community health centers (CHCs) within the group had an average efficiency score of 1.046. Moreover, the Luohu Hospital Group's average total factor productivity change (TFPCH) increased by 2.5%, primarily due to gains in technical efficiency change (EFFCH), which offset declines in technical progress change (TECHCH). The efficiency scores of CHCs were notably affected by the ratio of general practitioners (GPs) to health technicians and the availability of home hospital beds.

CONCLUSION

The reform in the Luohu healthcare system has shown preliminary success, but continuous monitoring is necessary. Future strategies should focus on strengthening technological innovation, training GPs, and implementing the home hospital bed policy. These efforts will optimize the efficiency of health resource allocation and support the integration and development of resources within the medical consortium.

摘要

目的

本研究旨在评估罗湖医院集团改革后的效率和生产力,并确定影响效率的因素,以支持医疗联合体的未来发展。

方法

使用超效率基于松弛的数据包络分析(SE-SBM-DEA)模型、Malmquist 生产力指数(MPI)和 Tobit 回归分析了 2015 年至 2021 年深圳和罗湖医院集团的卫生资源数据,以评估改革后效率和生产力的变化,并确定改革后效率的决定因素。

结果

改革后,罗湖医院集团内部卫生资源配置效率提高了 33.87%。集团内的社区卫生服务中心(CHC)平均效率得分为 1.046。此外,罗湖医院集团的总要素生产率变化(TFPCH)平均增长了 2.5%,主要得益于技术效率变化(EFFCH)的提高,抵消了技术进步变化(TECHCH)的下降。CHC 的效率得分受到全科医生(GP)与卫生技术人员比例以及家庭病床供应的显著影响。

结论

罗湖医疗体系的改革已经取得初步成功,但仍需持续监测。未来的策略应侧重于加强技术创新、培训全科医生和实施家庭病床政策。这些努力将优化卫生资源配置效率,并支持医疗联合体内部资源的整合和发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2ba/11390686/3384e0de4547/fpubh-12-1395633-g001.jpg

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