基于DEA模型的2016年我国中医类医院服务效率评价
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摘要
目的:对2016年全国31个省、市、自治区中医类医院服务效率进行整体评价,为实现资源优化配置提供参考。方法:结合DEA模型中的C2R模型与BC2模型对31个省、市、自治区中医类医院实有床位、卫生技术人员、机构数投入与出院人数、诊疗人次产出进行综合效率、单纯技术效率及规模效率评价。结果:31个省、市、自治区中医类医院综合效率、单纯技术效率、规模效率均值分别为0.868、0.912、0.955。综合效率偏低说明资源投入与产出失衡发展,存在一定程度资源浪费现象。累计6个(19.36%)省、市、自治区实现DEA有效发展,25个(80.64%)表现为DEA无效发展。DEA无效发展的省、市、自治区中,12个(48%)表现规模报酬递增,可通过适当增加投入规模实现最优发展;11个(44%)为规模报酬递减,可通过合理限制资源投入水平以提高效率水平;2个(8%)为规模报酬不变,说明实现可持续发展。结论:省际中医类医院发展效率整体呈现规模效率>单纯技术效率>综合效率且以DEA无效发展,说明资源投入规模趋向合理但有效利用能力较低,以机构投入冗余及诊疗人次产出不足为主的发展现状成为制约各省、市、自治区中医类医院效率优化发展的关键因素。
Objective: To evaluate the service efficiency of 31 provinces, municipalities and autonomous regions of China in 2016, and to provide reference for optimizing the allocation of resources. Methods: Combined with the C2 R model and BC2 model in DEA model, the comprehensive efficiency, pure technical efficiency and scale efficiency of TCM hospitals in 31 provinces, municipalities and autonomous regions were evaluated. Results: The mean values of comprehensive efficiency, technical efficiency and scale efficiency of the hospitals respectively were 0.868, 0.912 and 0.955. The low comprehensive efficiency indicates that there is a certain degree of waste of resources due to the unbalanced development of resources input and output. 6 provinces, municipalities and autonomous regions have achieved effective development of DEA, 25 of which are manifested as ineffective development of DEA. Among the provinces, municipalities and autonomous regions with ineffective development of DEA, 12(48%) show increasing returns to scale, which can achieve optimal development by increasing investment scale appropriately; 11(44%) show decreasing returns to scale, which can improve efficiency level by reasonably limiting the level of resource input; and 2(8%) show that sustainable development can be achieved by keeping scale returns unchanged. Conclusion: The overall development efficiency of provincial TCM hospitals shows scale efficiency > pure technical efficiency>comprehensive efficiency and ineffective development of DEA, which indicates that the scale of resource input tends to be reasonable but the ability of effective utilization is low. The development status of redundancy of institutional input and insufficient output of medical personnel has become the key factor restricting the optimization of efficiency of TCM hospitals in provinces, municipalities and autonomous regions.
Objective: To evaluate the service efficiency of 31 provinces, municipalities and autonomous regions of China in 2016, and to provide reference for optimizing the allocation of resources. Methods: Combined with the C2 R model and BC2 model in DEA model, the comprehensive efficiency, pure technical efficiency and scale efficiency of TCM hospitals in 31 provinces, municipalities and autonomous regions were evaluated. Results: The mean values of comprehensive efficiency, technical efficiency and scale efficiency of the hospitals respectively were 0.868, 0.912 and 0.955. The low comprehensive efficiency indicates that there is a certain degree of waste of resources due to the unbalanced development of resources input and output. 6 provinces, municipalities and autonomous regions have achieved effective development of DEA, 25 of which are manifested as ineffective development of DEA. Among the provinces, municipalities and autonomous regions with ineffective development of DEA, 12(48%) show increasing returns to scale, which can achieve optimal development by increasing investment scale appropriately; 11(44%) show decreasing returns to scale, which can improve efficiency level by reasonably limiting the level of resource input; and 2(8%) show that sustainable development can be achieved by keeping scale returns unchanged. Conclusion: The overall development efficiency of provincial TCM hospitals shows scale efficiency > pure technical efficiency>comprehensive efficiency and ineffective development of DEA, which indicates that the scale of resource input tends to be reasonable but the ability of effective utilization is low. The development status of redundancy of institutional input and insufficient output of medical personnel has become the key factor restricting the optimization of efficiency of TCM hospitals in provinces, municipalities and autonomous regions.
引文
[1]张淼丽,庞震苗,徐庆锋,等.广东省珠三角地区中医药服务能力的效率评价[J].现代医院管理,2015,15(4):22-24.
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[4]白冰楠,鄢锴灵,徐阅,等.基于超效率DEA的我国省际中医类医院服务效率分析[J].中国医院,2018,22(8):24-26.
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[8]鄢锴灵,白冰楠,徐阅,等.基于超效率DEA模型的北京市政府办中医类医院卫生资源配置利用效率评价[J].中国医院,2018,22(9):36-38.
[9]刘兵,曾建丽,梁林,等.基于DEA的地区科技人才资源配置效率评价[J].科技管理研究,2018,14(8):49-56.
[10]霍海英,吴维民.基于DEA的广西26家县级医院相对效率评价[J].中国卫生事业管理,2012,29(11):834-836.
[11]赵宁志,高茗,张玉琴,等.医院规模建设与内涵建设的探讨[J].江苏卫生事业管理,2011,2(22):74-75.
[12]卢苇,杨鹏,姚健,等.基层综合医院中医学科建设的实践与体会[J].中医药管理杂志,2016,22(8):25-27.
[13]何思长,刘志会,赵大仁,等.2009年~2014年我国中医医院的资源配置情况分析[J].中国医疗管理科学,2016(4):47-51
[14]张晓欢,张云飞.中医药供给侧结构性改革研究[J].中国市场,2018(23):6-8.
[15]沈鹏悦,耿蕊,寿文静,等.我国中医类医院医疗卫生资源区域配置分析[J].中国卫生统计,2018(3):445-448.
[2]洪宝林,房耘耘,程薇,等.我国中医医疗服务体系的现状及问题[J].中国卫生经济,2010,29(9):33-35.
[3]赵大仁,刘志会,何思长,等.基于DEA与RSR的我国中医类医院医疗服务效率的综合评价[J].中国卫生统计,2017,34(4):598-601.
[4]白冰楠,鄢锴灵,徐阅,等.基于超效率DEA的我国省际中医类医院服务效率分析[J].中国医院,2018,22(8):24-26.
[5]张桂林,潘习龙.基于数据包络分析方法的北京市农村基本公共卫生服务项目效率评价[J].北京大学学报,2013,45(2):264-268.
[6]袁淑婷,马晨骋,石学峰,等.基于数据包络分析的北京市医院运行效率评价[J].中国社会医学杂志,2018,35(3):288-291.
[7]曾雁冰,蔡伦,孙卫,等.基于DEA模型分析我国公立医院运行效率[J].中国卫生统计,2018,35(1):47-51.
[8]鄢锴灵,白冰楠,徐阅,等.基于超效率DEA模型的北京市政府办中医类医院卫生资源配置利用效率评价[J].中国医院,2018,22(9):36-38.
[9]刘兵,曾建丽,梁林,等.基于DEA的地区科技人才资源配置效率评价[J].科技管理研究,2018,14(8):49-56.
[10]霍海英,吴维民.基于DEA的广西26家县级医院相对效率评价[J].中国卫生事业管理,2012,29(11):834-836.
[11]赵宁志,高茗,张玉琴,等.医院规模建设与内涵建设的探讨[J].江苏卫生事业管理,2011,2(22):74-75.
[12]卢苇,杨鹏,姚健,等.基层综合医院中医学科建设的实践与体会[J].中医药管理杂志,2016,22(8):25-27.
[13]何思长,刘志会,赵大仁,等.2009年~2014年我国中医医院的资源配置情况分析[J].中国医疗管理科学,2016(4):47-51
[14]张晓欢,张云飞.中医药供给侧结构性改革研究[J].中国市场,2018(23):6-8.
[15]沈鹏悦,耿蕊,寿文静,等.我国中医类医院医疗卫生资源区域配置分析[J].中国卫生统计,2018(3):445-448.