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健康与生产力管理与改善住院医疗保健效率相关:使用 2021 财年床位功能报告进行的横断面研究。

Health & Productivity Management Associated With Improved Efficiency of Inpatient Health Care: Cross-sectional Study Using FY2021 Bed Function Report.

机构信息

Teikyo University Graduate School of Public Health, Itabashi-ku, Tokyo, Japan.

出版信息

Inquiry. 2024 Jan-Dec;61:469580241271299. doi: 10.1177/00469580241271299.

Abstract

This study examined the relationship between health and productivity management (H&PM) and inpatient health care efficiency in hospitals. This cross-sectional study is based on 1108 hospitals using data from the FY2021 Bed Function Report. The presence of Certified H&PM Organization was the proxy variable for H&PM implementation. The efficiency value obtained using the input-oriented Banker-Charners-Cooper model of data envelopment analysis was a proxy variable for inpatient health care efficiency. The input variables were the number of hospital beds, registered physicians, ward nurses, and other staff members in the ward. The output variable was the total number of patients in the ward per year. We conducted a Wilcoxon rank-sum test and compared certified and non-certified hospitals. The efficiency value was the objective variable, and certification presence was the explanatory variable. We used a stepwise method, including adjustment variables, to confirm whether the certification presence remained in the final multiple regression model. Efficiency was significantly higher in certified hospitals than non-certified hospitals. Certification presence remained in the final multiple regression model (β = .027, CI = -0.004 to 0.057, P = .085). Although not statistically significant, certified hospitals tended to have higher efficiency compared to non-certified hospitals. These findings suggested that hospitals that actively engage in H&PM may have higher efficiency in inpatient health care. However, further research is needed to establish the causal relationship.

摘要

本研究旨在探讨健康与生产力管理(H&PM)与医院住院医疗效率之间的关系。本横断面研究基于使用 2021 财年床位功能报告数据的 1108 家医院。经认证的 H&PM 组织的存在是 H&PM 实施的替代变量。使用数据包络分析的投入导向 Banker-Charners-Cooper 模型获得的效率值是住院医疗效率的替代变量。投入变量为医院病床数、注册医师数、病房护士数和病房其他工作人员数。输出变量为每年病房内的患者总数。我们进行了 Wilcoxon 秩和检验,并比较了认证医院和非认证医院。效率值为因变量,认证存在为自变量。我们使用逐步法,包括调整变量,以确认认证存在是否保留在最终的多元回归模型中。认证医院的效率明显高于非认证医院。认证存在保留在最终的多元回归模型中(β=0.027,CI=-0.004 至 0.057,P=0.085)。虽然没有统计学意义,但认证医院的效率往往高于非认证医院。这些发现表明,积极参与 H&PM 的医院在住院医疗方面可能具有更高的效率。然而,需要进一步的研究来建立因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4153/11526217/35c10e681b10/10.1177_00469580241271299-fig1.jpg

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