基于数据包络分析的军队医院药学部门效率评价

Data envelopment analysis-based evaluation of pharmacy efficiencies of military hospitals

目的:评价军队医院药学部门的相对效率,为医院合理配置药学资源提供决策参考。方法:运用数据包络分析方法(DEA),以药学人员、设施设备、实际使用面积、发展建设经费为投入要素,以药品收费、临床药学服务、药学信息服务、学术成果、科研活动等为产出要素,评价71家军队医院药学部门的生产效率,对不同经济条件假设下的评价结果进行效率分解,以评估各部门的规模效率、要素处置效率和纯技术效率;结果:数据包络分析表明28家医院的药学部门相对效率值为1,DEA有效,43家医院药学部门相对效率<1,投入要素存在效率损失;多元线性回归分析表明,医院编制等级、医院病床展开数、临床药师下临床的时间、人员新进率、本科以上学历的药学专业技术人员比例、病床使用率等因素与5项产出要素值相关,并建立5个多元线性回归方程;Pearsonχ2检验表明规模效率、要素处置效率和纯技术效率相对无效的药学部门在不同的医院编制等级中的分布差异有统计学意义,要素处置效率、纯技术效率相对无效的药学部门在不同地区的分布差异有统计学意义;Pear-son两两相关分析结果表明药学部门DEA相对效率值与医院等级相关,与医院所属地区和所在城市无关。结论:军队医院的编制等级以及由此引起的资源和技术力量的有效配置可能是药学部门提高效率的关键因素。

Objective：To evaluate the relative efficiency of pharmacies in military hospitals,so as to provide evidence for rational allocation in medicinals resources in hospitals. Methods： Data envelopment analysis （DEA） was used to evaluate relative efficiencies of 71 pharmacies in military hospitals （also as decision making units, DMUs）. The input factors included pharmacy personnels, equipment, areas of pharmacies, and development funds; the output factors included drug charge, clinical pharmaceutical service, pharmaceutical information service,academic achievements and research activities. Decomposition of the pharmacy efficiencies under different economic conditions was performed to evaluate the scale efficiency （SE）,the resource disposal efficiency （DE） and the technical efficiency （TE）. Pearson correlation analysis and chi-square test were used for statistic analysis. Results：DEA results showed that the relative efficiency of the 28 pharmacies was 1, they were DEA effective; the relative efficiency of the 43 DMUs was less than 1,indicating the presence of efficiency loss. Multiple linear regression analysis showed that hospital grade, bed number, clinical time of pharmacists, HR flow-in rate, proportions of pharmacists with undergraduate or graduate diploma, bed utilization rate, etc. were correlated with the 5 output factors. Five multiple linear regression equation were established. We also found that the distribution of pharmacies of SE, DE, and TE non- efficiency were significantly different between hospitals of different grades; the distribution of pharmacies of DE, and TE non-efficiency were significantly different between hospitals located in different regions. Pearson correlation analysis showed that the DEA efficiency of pharmacies was correlated with hospital grade, not with the area or the city where the hospitals located. Conclusion： The grades of military hospitals and the subsequent effective allocation of resources and technologies may be the key factor to increase the efficiencies of pharmacies.