重庆市县级及以上医院投入产出效率分析

Analysis of Input and Output Efficiency of above and in County-level Hospitals Chongqing

目的分析重庆市县级及以上医院投入产出效率,为科学制定卫生资源配置规划提供可靠依据。方法收集1 027所县级及以上医院投入产出数据,采用描述性分析、数据包络分析进行评价。结果总体有效医院为13所(占10.2%),纯技术有效医院为19所(占15%),规模有效医院为13所(占10.2%),非规模有效医院中,113所为规模收益递减(占99.1%)。各经济圈中,渝西经济走廊医院平均总体有效率最高(0.655),库区次之(0.609),都市经济圈最低(0.577)。各级别医院中,三级医院平均总体有效率最高(0.774),一级医院次之(0.660),二级医院最低(0.556)。结论重庆市县级及以上医院投入产出效率不高,应合理控制医院规模,提高管理水平和医疗服务质量,形成中小型医院特色,建立健全医保制度,全方位提高医院效率。

Objective To analyze the input and output efficiency of above and at county-level hospitals in Chongqing and to offer reliable evidence for modifying health policy in health resources allocation. Methods The input and output data of 1027 at and above county-level hospitals was collected, then the descriptive analysis and data envelopment analysis （DEA） were used. Results DEA results showed that there were 13 overall technical effective hospitals（taking up 10.2%）, 19 pure technical effective hospitals（taking up 15%） and 13 scale effective hospitals（taking up 10.2%）. 113 of the114 null scale effective hospitals were decreasing in scale efficiency. Metropolitan Advanced Economic Sphere had the highest efficiency score, which was 0.655, then West Chongqing Economic Corridor with the score of 0.609, and the lowest Ecological Economic Zone in Three Gorges, which was 0.577. The tertiary hospitals had the highest efficiency score, which was 0.774, then the primary hospitals with the score of 0.660, while the secondary hospitals had the lowest efficiency score, which was 0.556. Conclusion The input and output efficiency of at and above county-level hospitals in Chongqing are generally low. The governors should control the scale of hospitals, improve management level and medical service quality, establish characteristics of medium-small type hospitals, and establish and perfect medical insurance system to improve efficiency of hospitals.