基于数据包络分析的京沪两地三级甲等综合性医院运营效率比较研究

Data envelopment analysis-based comparative analysis for operational efficiency of upper first-class general hospitals in Beijing and Shanghai

目的采用数据包络分析(DEA)方法比较京沪两地三级甲等综合性医院的运营效率,分析运营特点和不足并提出发展建议,探讨DEA方法在医院运营管理中的应用价值。方法采集2009年度上海市和北京市各12家三级甲等综合性医院的4项投入指标和4项产出指标,利用DEA方法的BCC模型分析两地三级甲等综合性医院的运营效率。结果京沪两地医院运营效率整体较高,运营有效的医院比例大于国内其他地区;上海市三级甲等综合性医院的整体综合效率、纯技术效率和规模效率略高于北京市三级甲等综合性医院水平,但差异无统计学意义(P>0.05)。在上海市非DEA有效的个别医院中,存在开放床位数和固定资产投入的冗余;京沪两地三级甲等综合性医院间投入产出指标中的职工总数和固定资产总额2项指标比较,差异有统计学意义(P<0.01和P<0.05)。结论 DEA分析是医院多投入和多产出的综合运营效率评价的有效手段,是医院管理及卫生决策有效的辅助工具。京沪两地三级甲等综合性医院综合运营效率较高,且水平相当;进一步发展的对策是严格控制医院规模和投入,加强内涵建设,降低运营成本,合理配置医疗资源,不断提高精细化、专业化和科学化管理水平。

Objective To compare operational efficiency, characteristics, and shortage of upper first-class general hospitals （UFGHs） in Beijing and Shanghai by using data envelopment analysis （DEA） method, and to provide suggestions and discuss the evaluation of DEA method. Methods Four input indexes and 4 output indexes in 2009 of 12 UFGHs in Shanghai and 12 UFGHs in Beijing were collected. BCC model of DEA method was used to analyze the operational efficiency of these hospitals. Results The operational efficiency and ratio of efficiency of UFGHs in Beijing and Shanghai were higher than hospitals in other cities of China. Compared to Beijing, the overall efficiency, pure technical efficiency, and scale efficiency of UFGHs in Shanghai were higher, but there was no significant difference （P 〉 0.05）. In non-DEA effective hospitals in Shanghai, there was redundancy of open beds and fixed assets investment. There were significant differences in total employees and fixed assets investment of input and output indexes of UFGHs in both cities （P 〈 0. 01, P 〈0.05）. Conclusion DEA is an effective method to evalute multiple inputs and outputs of hospitals and an assisted tool for hospital management and health decision making. The hospitals＇ operational efficiency in Beijing and Shanghai are equivalent in high level. The way to increase hospitals＇ operational efficiency is controlling scale and input, strengthening internal constructions, reducing operational costs, rationally allocating medical resources, and constantly improving the management level in refinement, specialization, and scientization.