基于Bootstrap-DEA法的武汉市三级公立医院技术效率评价
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摘要
目的:综合评价武汉市三级公立医院的技术效率,为提高三级医院技术效率提供政策建议。方法:采用Bootstrap-DEA法评价武汉市19家公立医院2017年度的技术效率,通过不同投入产出指标的选取构建4种分析模型,运用MaxDEA软件测算纠偏前后样本医院技术效率值。结果:武汉市19家公立医院技术效率适中,纠偏前技术均值为0.8781,纠偏后技术效率均值为0.7922,偏差达0.0859。结论:武汉市三级公立医院技术效率尚未达到最优,仍具备提升空间。建议以公立医院改革为契机,科学确定三级医院规模标准,同时积极构建医疗联合体,做好医院间帮扶工作。
Objective: To evaluate the technical efficiency of municipal & district public tertiary hospitals in Wuhan city by using bootstrap data envelope analysis and to provide policy suggestions for improving the technical efficiency of tertiary hospitals. Methods: Bootstrap-DEA method was used to evaluate the technical efficiency of 19 public tertiary hospitals of Wuhan in 2017. Four models were constructed by selecting different input-output indicators. MaxDEA was used to calculate the technical efficiency of sample hospitals before and after correction. Results: The technical efficiency of 19 municipal & district public tertiary hospitals in Wuhan is at moderate level. The average technical efficiency before correction is 0.8781, and after is 0.7922. The bias is 0.0859. Conclusions: The technical efficiency of municipal & district tertiary public hospitals in Wuhan have not reached the optimum level. It is suggested that scale standard of tertiary hospitals should be determined scientifically and the medical treatment alliance should be established to assist same level hospitals.
Objective: To evaluate the technical efficiency of municipal & district public tertiary hospitals in Wuhan city by using bootstrap data envelope analysis and to provide policy suggestions for improving the technical efficiency of tertiary hospitals. Methods: Bootstrap-DEA method was used to evaluate the technical efficiency of 19 public tertiary hospitals of Wuhan in 2017. Four models were constructed by selecting different input-output indicators. MaxDEA was used to calculate the technical efficiency of sample hospitals before and after correction. Results: The technical efficiency of 19 municipal & district public tertiary hospitals in Wuhan is at moderate level. The average technical efficiency before correction is 0.8781, and after is 0.7922. The bias is 0.0859. Conclusions: The technical efficiency of municipal & district tertiary public hospitals in Wuhan have not reached the optimum level. It is suggested that scale standard of tertiary hospitals should be determined scientifically and the medical treatment alliance should be established to assist same level hospitals.
引文
[1]武汉市人民政府. 武汉市人民政府关于印发全面推进全市公立医院综合改革实施方案的通知[EB/OL]. [2016-12-14]. http://www.wuhan.gov.cn/hbgovinfo_47/szfggxxml/zcfg/gfxwj/201701/t20170105_97577.html.
[2]SIMAR L, WILSON P W. A general methodology for bootstrapping in non-parametric frontier models[J]. Journal of applied statistics, 2000, 27(6):779-802.
[3]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(20):40-45.
[4]CHENG Z C, CAI M, TAO H B, et al. The efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis[J]. BMJ Open, 2016, 6(11):e011911.
[5]L O’NEILL, M RAUNER, K HEIDENBERGER, et al. A cross-national comparison and taxonomy of DEA-based hospital efficiency studies[J].Socio-economic planning sciences,2008,42(3): 158-189.
[6]LI H, DONG S P. Measuring and benchmarking technical efficiency of public hospitals in Tianjin, China: a bootstrap–data envelopment analysis approach[J].Inquiry.2015:52.
[7]LI H, DONG S P, LIU T. Relative efficiency and productivity: a preliminary exploration of public hospitals in Beijing, China[J]. BMC Health Services Research, 2014, 14(1):158.
[8]石义全, 钱振华, 成刚. 指标选择对医院效率评价的影响——以2010年省级数据DEA模型为例[J]. 中国卫生政策研究,2012(3):67-72.
[9]尹刚. 基于DEA模型的武汉市36家公立医院运行效率实证研究[D]. 湖北大学, 2018.
[10]方鹏骞, 李曼琪, 李文敏. 试论三级公立医院在医疗联合体中的引领作用[J]. 中国医院管理,2018,38(5):1-3.
[2]SIMAR L, WILSON P W. A general methodology for bootstrapping in non-parametric frontier models[J]. Journal of applied statistics, 2000, 27(6):779-802.
[3]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(20):40-45.
[4]CHENG Z C, CAI M, TAO H B, et al. The efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis[J]. BMJ Open, 2016, 6(11):e011911.
[5]L O’NEILL, M RAUNER, K HEIDENBERGER, et al. A cross-national comparison and taxonomy of DEA-based hospital efficiency studies[J].Socio-economic planning sciences,2008,42(3): 158-189.
[6]LI H, DONG S P. Measuring and benchmarking technical efficiency of public hospitals in Tianjin, China: a bootstrap–data envelopment analysis approach[J].Inquiry.2015:52.
[7]LI H, DONG S P, LIU T. Relative efficiency and productivity: a preliminary exploration of public hospitals in Beijing, China[J]. BMC Health Services Research, 2014, 14(1):158.
[8]石义全, 钱振华, 成刚. 指标选择对医院效率评价的影响——以2010年省级数据DEA模型为例[J]. 中国卫生政策研究,2012(3):67-72.
[9]尹刚. 基于DEA模型的武汉市36家公立医院运行效率实证研究[D]. 湖北大学, 2018.
[10]方鹏骞, 李曼琪, 李文敏. 试论三级公立医院在医疗联合体中的引领作用[J]. 中国医院管理,2018,38(5):1-3.