浙江省乡镇卫生院规模适宜性评价

Scale Evaluation on Township Hospitals in Zhejiang Province

目的了解乡镇区划不断调整后的乡镇卫生院是否存在规模小、效率低等问题,评价浙江省乡镇卫生院的规模适宜性。方法利用数据包络分析方法和浙江省乡镇卫生院的年报数据进行分析。结果:全部样本单元(1177所乡镇卫生院)的整体效率平均值为0.72,规模效率为0.95;60.2%的样本单元规模报酬递减;影响规模效率高低的因素主要有职工数、执业(助理)医师数、设备数、每名职工实际占用床日及所在县、区的经济类型等。结论:(1)半数以上乡镇卫生院规模偏大,应重视内涵建设与合理控制乡镇卫生院规模。(2)职工数和执业(助理)医师数量总体上偏大,但仍有11.0%的乡镇卫生院执业医师数为零,因此,应着重提高人员素质。(3)增加设备数量,提高工作效率(如每名职工占用床日等指标)可以提高规模效率。(4)乡镇卫生院床位一般以30张以下较好,不宜超过100张;职工数控制在60人以下,不宜超过90人。

OBJECTS In order to know the scale efficiency and evaluate the scale of the township hospitals in Zhejiang Province after continual township zoning.METHODS The data of 1 177 township hospitals which getting from annual health information system of Zhejiang Province is analyzed by the method of Data Envelopment analysis and multiple regression.RESULTS The efficiency of the sample units is 0.72,the scale efficiency 0.95.About 60% of the township hospitals are too large in size.The level of scale efficiency is affected by the number of staff and medical practitioners,equipments,hospital stay per employee and economic level of the region.CONCLUSIONS Over half of the township hospitals are too large in size.In better regional economic level,the scale of hospital should be controlled more strictly.The number of staff and the number of medical practitioners have been too large for the scale efficiency.Adding equipments and promoting number of hospital stay per workers and other efficient indexes may contributes to scale efficiency.It is appropriate that each township hospital keep no more than 30 beds and 60 workers,especially no more than 100 beds and 90 workers.