School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
BMJ Open. 2024 Oct 29;14(10):e088462. doi: 10.1136/bmjopen-2024-088462.
Analysing and evaluating how efficiently health resources are allocated to county-level Traditional Chinese Medicine (TCM) hospitals in Zhejiang Province, this study aims to provide empirical evidence for improving operational efficiency and optimising resource allocation in these hospitals.
The study employed a three-stage Data Envelopment Analysis (DEA) model to assess efficiency, using data from 68 county-level TCM hospitals. Four input and five output variables related to TCM services were selected for the analysis.
The first-stage DEA results indicated that in 2022, the technical efficiency (TE) of TCM hospitals in Zhejiang Province was 0.788, the pure technical efficiency (PTE) was 0.876 and the scale efficiency (SE) was 0.903. The classification of hospitals into four groups based on the bed size showed statistically significant differences in returns to scale (p<0.001). The Stochastic Frontier Analysis regression results were significant at the 1% level across four regressions, showing that environmental variables such as per capita GDP, population density and the number of hospitals impacted efficiency. In the third stage DEA, after adjusting the input variables, the TE, PTE and SE improved to 0.809, 0.833 and 0.917, respectively. The adjusted mean TE rankings by region were West (0.860) > East (0.844) > South (0.805) > North (0.796) > Central (0.731).
There is an imbalance between the inputs and outputs of county-level TCM hospitals. Each region must consider factors such as the local economy, population and medical service levels, along with the specific development characteristics of hospitals, to reasonably determine the scale of county-level TCM hospital construction. Emphasis should be placed on improving hospital management and technical capabilities, coordinating regional development, promoting the rational allocation and efficient use of TCM resources and enhancing the efficiency of resource allocation in county-level TCM hospitals.
分析和评估浙江省县级中医院的卫生资源配置效率,为提高医院运营效率和优化资源配置提供实证依据。
本研究采用三阶段数据包络分析(DEA)模型评估效率,数据来自 68 家县级中医院。选择了与中医服务相关的四个投入和五个产出变量进行分析。
第一阶段 DEA 结果表明,2022 年浙江省中医院的技术效率(TE)为 0.788,纯技术效率(PTE)为 0.876,规模效率(SE)为 0.903。根据床位数将医院分为四组,在规模报酬上存在显著差异(p<0.001)。四个回归的随机前沿分析回归结果均在 1%水平上显著,表明人均 GDP、人口密度和医院数量等环境变量对效率有影响。在第三阶段 DEA 中,调整投入变量后,TE、PTE 和 SE 分别提高到 0.809、0.833 和 0.917。按地区调整后的平均 TE 排名为西部(0.860)>东部(0.844)>南部(0.805)>北部(0.796)>中部(0.731)。
县级中医院投入产出存在不平衡。各地区应根据当地经济、人口和医疗服务水平等因素,结合医院的具体发展特点,合理确定县级中医院建设规模。应重视提高医院管理和技术能力,协调区域发展,促进中医资源的合理配置和高效利用,提高县级中医院的资源配置效率。