基于DEA-Tobit模型的江苏省三级医院运行效率研究
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摘要
目的:评价2017年江苏省58所三级甲等医疗机构运行的相对效率,分析大型医疗机构运行现况,并基于优化医疗资源配置,推动大型三级医院合理运转的角度提出建议。方法:通过数据包络分析法对三级甲等医疗机构的技术效率和规模效率进行比较研究,并利用Tobit模型探索效率的影响因素。结果:江苏省58所三级甲等医院的综合效率相对较低,仅17.24%的医院DEA有效,机构运行效率存在地区差异,苏南地区存在医疗资源投入冗余,苏中地区资源投入不足。医院卫生技术人员总数、人员床位比、平均住院日与医护比影响机构运行效率。结论:结合区域医疗机构运行现况,从省级纵观层面上合理规划医疗资源配置,积极引导大型三级甲等医院内涵发展,不断提高机构管理能力和资源利用率。
Objectives:To assess the relative efficiency of 58 Tertiary Hospitals in Jiangsu in 2017,which would help to put forward some suggestions considering optimizing the allocation of medical resources and promoting the rational operation of these large hospitals. Methods:Data Envelopment Analysis(DEA)was used to compare the technical efficiency and scale efficiency of 58 Tertiary Hospitals,Tobit model was employed to explore the influencing factors of efficiency. Results:The comprehensive efficiency of these hospitals were relatively low,only 17.24% in the interval of effectiveness. There are significant differences in efficiency considering different districts. Input redundancy was indeed in the southern part of Jiangsu Province while the insufficient investment in the middle part.The efficiency was influenced by the total number of health technical staffs,staff bed ratio,length of stay,and ratio of doctor and nurse.Conclusion:Regional medical resource planning should be made from the perspective of the whole province considering the operation status of hospitals. The large tertiary hospitals should focus on the connotation development,dedicated to improve the ability of management and utilization of resources.
Objectives:To assess the relative efficiency of 58 Tertiary Hospitals in Jiangsu in 2017,which would help to put forward some suggestions considering optimizing the allocation of medical resources and promoting the rational operation of these large hospitals. Methods:Data Envelopment Analysis(DEA)was used to compare the technical efficiency and scale efficiency of 58 Tertiary Hospitals,Tobit model was employed to explore the influencing factors of efficiency. Results:The comprehensive efficiency of these hospitals were relatively low,only 17.24% in the interval of effectiveness. There are significant differences in efficiency considering different districts. Input redundancy was indeed in the southern part of Jiangsu Province while the insufficient investment in the middle part.The efficiency was influenced by the total number of health technical staffs,staff bed ratio,length of stay,and ratio of doctor and nurse.Conclusion:Regional medical resource planning should be made from the perspective of the whole province considering the operation status of hospitals. The large tertiary hospitals should focus on the connotation development,dedicated to improve the ability of management and utilization of resources.
引文
[1]杨坚,谢添,金晶,等.我国各省分级诊疗政策分析[J].中国卫生经济,2016,35(1):14-17.
[2]董四平,左玉玲,陶红兵,等.中国医院效率DEA研究分类与投入产出指标分析[J].中国卫生政策研究,2014,7(10):40-45.
[3]雷海潮,周志男,谢学勤,等.基于数据包络分析的三级医院适宜规模研究[J].中国医院管理,2014,34(3):11-14.
[4]Charnes A,Cooper W W,Rhodes E.Measuring the efficiency of decision making units[J].European Journal of Operational Research,1978,2(6):429-444.
[5]张瑞华,刘莉,李维华,等.基于数据包络分析的我国31个省市医疗卫生服务效率评价[J].中国卫生经济,2011,30(2):69-72.
[6]范洁,黄晓光,冷明祥,等.基于数据包络分析的江苏省卫生资源配置效率评价[J].卫生经济研究,2016,33(4):38-40.
[7]徐颖,申俊龙,高山.基于超效率-基于松弛测度的江苏省地级市医疗卫生机构技术效率研究[J].山西医药杂志,2016,45(2):123-127.
[8]宋慧勇.基于DEA的江苏省卫生机构服务效率分析[J].江苏科技信息,2016,33(15):4-8.
[2]董四平,左玉玲,陶红兵,等.中国医院效率DEA研究分类与投入产出指标分析[J].中国卫生政策研究,2014,7(10):40-45.
[3]雷海潮,周志男,谢学勤,等.基于数据包络分析的三级医院适宜规模研究[J].中国医院管理,2014,34(3):11-14.
[4]Charnes A,Cooper W W,Rhodes E.Measuring the efficiency of decision making units[J].European Journal of Operational Research,1978,2(6):429-444.
[5]张瑞华,刘莉,李维华,等.基于数据包络分析的我国31个省市医疗卫生服务效率评价[J].中国卫生经济,2011,30(2):69-72.
[6]范洁,黄晓光,冷明祥,等.基于数据包络分析的江苏省卫生资源配置效率评价[J].卫生经济研究,2016,33(4):38-40.
[7]徐颖,申俊龙,高山.基于超效率-基于松弛测度的江苏省地级市医疗卫生机构技术效率研究[J].山西医药杂志,2016,45(2):123-127.
[8]宋慧勇.基于DEA的江苏省卫生机构服务效率分析[J].江苏科技信息,2016,33(15):4-8.