中山市各镇区基本公共卫生服务效率评价
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摘要
目的我国基本公共卫生服务补助经费逐年增加,已成为基层医疗机构重要收入来源。为提高补助资金使用效益,提升基层医疗机构服务绩效,本研究对中山市24个镇区基本公共卫生服务效率进行评价。方法收集2016年中山市24个镇区医疗机构有关基本公共卫生服务的投入和产出数据,运用数据包络分析(data envelopment analysis,DEA)的方法分析投入产出效率。结果中山市24个镇区基本公共卫生服务项目的综合技术效率、纯技术效率和规模效率平均值分别为0.833、0.968和0.860。5个镇区的综合效率为1,即DEA有效,19个DEA无效的镇区处于规模报酬递减阶段,均表现为规模低效率,其中8个镇区还同时存在纯技术低效率。投入产出方面,b、c、e、k、u和w镇区存在职工人数过多情况,f镇区的公共卫生补助存在冗余,以上镇区和x镇区均存在产出不足情况。结论中山市各镇区公共卫生服务综合效率低,存在经营规模不经济、职工人数过多情况、公共卫生补助存在冗余和产出不足情况。应控制各镇区医疗机构经营规模,加强内部经营管理,精简无效人员,提高资金使用效率。
OBJECTIVE The subsidy funds for basic public health services in China have increased year by year and become an important source of income for primary medical institutions.In order to improve the efficiency of subsidy funds and service performance of primary medical institutions,this study evaluated the efficiency of basic public health services in24 townships of Zhongshan city.METHODS Data envelopment analysis(DEA)was used to collect input and output data of basic public health services from 24 township medical institutions in Zhongshan city in 2016.RESULTS The average comprehensive technical efficiency,pure technical efficiency and scale efficiency of 24 basic public health service projects in Zhongshan were 0.833,0.968 and 0.860,respectively.The overall efficiency of five towns was 1,that was DEA was effective.19 towns with ineffective DEA were in the stage of diminishing returns to scale,which were all characterized by low efficiency of scale.Among them,8 towns also had pure technical inefficiency.In terms of input and output,there were too many employees in b,c,e,k,u and w towns,redundant public health subsidies in f towns,and insufficient output in both above towns and x towns.CONCLUSIONS The comprehensive efficiency of public health services in Zhongshan is low.There are some problems,such as uneconomical scale of operation,excessive number of employees,redundancy of public health subsidies and insufficient output.It is necessary to control the operation scale of medical institutions in towns,strengthen internal management,streamline invalid personnel and improve the efficiency of fund use.
OBJECTIVE The subsidy funds for basic public health services in China have increased year by year and become an important source of income for primary medical institutions.In order to improve the efficiency of subsidy funds and service performance of primary medical institutions,this study evaluated the efficiency of basic public health services in24 townships of Zhongshan city.METHODS Data envelopment analysis(DEA)was used to collect input and output data of basic public health services from 24 township medical institutions in Zhongshan city in 2016.RESULTS The average comprehensive technical efficiency,pure technical efficiency and scale efficiency of 24 basic public health service projects in Zhongshan were 0.833,0.968 and 0.860,respectively.The overall efficiency of five towns was 1,that was DEA was effective.19 towns with ineffective DEA were in the stage of diminishing returns to scale,which were all characterized by low efficiency of scale.Among them,8 towns also had pure technical inefficiency.In terms of input and output,there were too many employees in b,c,e,k,u and w towns,redundant public health subsidies in f towns,and insufficient output in both above towns and x towns.CONCLUSIONS The comprehensive efficiency of public health services in Zhongshan is low.There are some problems,such as uneconomical scale of operation,excessive number of employees,redundancy of public health subsidies and insufficient output.It is necessary to control the operation scale of medical institutions in towns,strengthen internal management,streamline invalid personnel and improve the efficiency of fund use.
引文
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[2]成刚.数据包络分析方法与MaxDEA软件[M].北京:知识产权出版社,2014.
[3]张璐莹,应晓华,王笑,等.上海市市级医院运行效率的数据包络分析[J].中国卫生资源,2014,17(6):415-418.
[4]张玥.基于DEA模型的我国省际卫生服务效率评价[J].中国卫生统计,2018,35(4):559-562.
[5]Charnes A,Cooper WW,Rhode E.Measuring the efficiency of decision making units[J].Eur J Oper Res,1978,6(2):429-444.
[6]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(医学版),2013,45(2):264-268.
[7]万生新.基于数据包络分析的我国各地区公共卫生支出效率评价[J].科学技术与工程,2012,12(10):2391-2394.
[8]成刚,钱振华,孟庆跃.DEA在公共卫生项目目标管理中的应用[J].中国卫生经济,2008,27(3):33-36.
[9]Akazili J,Adjuik M,Jehu-Appiah C.Using data envelopment analysis to measure the extent of technical efficiency of public health centres in Ghana[J].BMC Int Health Hum Rights,2008,8:11.
[10]李萌,刘丽杭,王小万.基于DEA模型的湖南省29家社区卫生服务中心效率研究[J].中国卫生经济,2013,32(4):47-50.
[11]丁小磊,宋俐,沈文琪.基于数据包络分析法的江苏省基本公共卫生服务实施效率评价[J].中国全科医学,2016,19(13):1505-1509.
[12]朱先,欧阳俊婷,匡莉,等.广州市基本公共卫生服务效率评价与影响因素研究[J].卫生经济研究,2015(3):47-50.
[13]李显文,高越明,章燕丽.医疗机构数据包络分析中的指标选择[J].卫生经济研究,2009(2):12-13.
[14]黄晓霞,吴燕,王君燕,等.基于数据包络分析法的上海市闵行区社区卫生服务机构公共卫生服务效率评价[J].中国全科医学,2016,19(25):3085-3089.