从有偿服务看公立医疗卫生机构的运作效率

The efficiency model of the state-owned medical institutions

鉴于公立医院的财政投入比重过小 ,对医院运作效率的影响不典型 ,所以 ,该文运用投入产出定量模型 ,比较全国疾病控制中心的“财政投入模式 (计划包干模型 )”、“有偿服务模式 (市场运作模型 )”和“财政投入与有偿服务混合模式 (综合效率模型 )”的效率 ,发现三类模式的运作效率比为 1∶7.2∶2 .8,得出了目前的财政在投入量不足前提下 ,投入的效率低下 ,有偿服务虽有待规范 ,但是 ,其市场机制下的高运作效率 ,尤其是提高运作效率的激励机制却是值得借鉴的 ,疾控中心因为财政投入和有偿服务收入各约占总收入的一半 ,因而 ,总体运作效率也是计划包干的 2 .8倍。因而服务收费占总收入 90 %以上的医院 ,目前的运作效率总体并不低下 ,问题是补偿机制扭曲下 ,医院的运作效率朝着拓展业务收入、提供能够增收项目方向发展 ,从而医疗费用过快增长等成为问题。因此 。

This paper presents a quantitative analysis on the efficiency of the state-owned health institutions using Cobb-Douglas production function. It is demonstrated that there exist vast differences in the efficiency among government finance input, marketing mechanism, and combined models. The efficiency ratio of three models is 1∶7.2∶2.8. It is evident that the efficiency of hospitals is quite high. Because of the twisted reimbursement mechanism, the higher the efficiency of hospitals is, the more serious the social issues such as quickly increasing medical expenditure are. Therefore, the high efficiency of hospitals does not mean that the health institution in our country has the high efficiency.