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

Evaluation of the Implementation Efficiency of Basic Public Health Service in Jiangsu Province Based on Data Envelopment Analysis

目的评价江苏省基本公共卫生服务的实施效率。方法于2014年,根据地域及经济发展水平,在江苏省苏南、苏中和苏北3个区域分别选取13、7、12个县(市、区)的社区卫生服务中心和乡镇卫生院为研究对象。选取的县(市、区)同时也是江苏省基本公共卫生服务项目开展示范点。运用数据包络分析(DEA)法,以每万居民服务站点数(个)、每万居民拥有卫生技术人员数(人)、经费投入(万元)3个指标为投入指标,以健康教育知识讲座开展数(次)、老年人健康体检数(人次)、高血压患者规范管理数(人)、2型糖尿病患者规范管理数(人)、重性精神疾病患者规范管理数(人)、传染病报告数(起)6个指标为产出指标,通过规模报酬可变模型(BCC模型)对32个示范点基本公共卫生服务项目的实施效率进行分析。结果 32个示范点基本公共卫生服务项目的实施综合技术效率、纯技术效率和规模效率平均值分别为0.843、0.916、0.919。其中14个示范点综合技术效率值为1,即DEA有效;5个示范点虽然综合技术效率值小于1,但是纯技术效率值为1;13个示范点综合技术效率、纯技术效率和规模效率值均小于1。结论江苏省基本公共卫生服务项目的实施效率较高,卫生资源得到较有效利用,规模效率小于1的示范点基本处于规模效率递增阶段,可以通过增加投入来扩大产出。

Objective To evaluate the efficiency of the implementation of basic public health service in Jiangsu Province. Methods In 2014, according to regional development and economic level, we selected 13,7 and 12 counties（ cities,districts） respectively from south,central and north parts of Jiangsu Province and enrolled community health service centers and township health centers from these places as subjects. The counties（ cities and districts） selected were all pilot places for basic public health service items of Jiangsu Province. Using data envelopment analysis（ DEA） method,we established 3 input indexes,which were the number of service sites per 10 000 residents,the number of health workers per 10 000 residents and financial input（ 10 000 yuan）,and 6 output indexes,which were the times of lectures for the knowledge of health education,the number of elders receiving health examination, the number of hypertensive patients receiving standard management, the number of diabetic patients receiving standard management,the number of patients with severe mental illness receiving standard management and the number of cases of infectious disease reported. The implementation efficiency of the basic public health service items in the 32 pilot places was analyzed by BBC model. Results The average values of the comprehensive technological efficiency,pure technical efficiency and scale efficiency of the implementation of basic public health service items in the 32 pilot places were 0. 843,0. 916 and 0. 919 respectively. The comprehensive technological efficiency of 14 pilot places was 1,which indicated effective DEA; the comprehensive technological efficiency of 5 pilot places was less than 1, while their pure technological efficiency was 1; the comprehensive technological efficiency,pure technological efficiency and scale efficiency of13 pilot places were all less than 1. Conclusion Jiangsu Province has high implementation efficiency in basic public health service,and has effective use of health resources. The pilot places with scale efficiency less than 1 shows an increasing trend in scale efficiency,and their output can be expanded by increasing input.