基于DEA的三级医院规模经济分析

Data envelopment analysis on economies of scale of tertiary hospitals

目的:了解三级医院规模经济程度和适宜规模范围。方法:从浙江省64家综合性三级医院中抽取22家的2002年-2007年面板数据,利用数据包络分析方法有关模型计算规模效率,判断规模报酬区间。结果:22个医院132个单元按效率强度分组,规模相对有效组有16个医院48个单元(占36.4%),边缘无效组有19个医院76个单元(57.6%),明显无效组4个医院8个单元(6.0%);相对有效组床位均数为906,极差为410～1 874;规模有效率单元的比例呈U形变化,两头略高,以2004年较低;处于省会的医院的规模效率高于地处地市和县城;处于规模报酬不变区间单元数48个(占36.4%)。结论:少数单元(36.4%)呈规模经济;多数三级医院规模扩张太快,尤其是地处地市和县城者;三级医院适宜床位范围为400～1 800张,其中地处省会者宜控制在1 800张以下,地市和县城则在1 200张以下。

Objective： To understand the economies of scale of tertiary hospitals in Zhejiang province and make sure the appropriate number of beds of these hospitals.Methods： The panel data of 22 hospitals during 2002 to 2007 chosen from 64 tertiary general hospitals was collected and the scale efficiency and the returns to scale were calculated by data envelopment analysis（DEA）.Results： Grouped according to the intensity of scale efficiency,the relative effective group had 48 units（36.4%） of 16 hospitals in 132 units of 22 hospitals,the edged invalid group 76 units（57.6%） of 19 hospitals,the obviously ineffective group 8 units（6.0%） of 4 hospitals.The relatively effective group had 906 beds on average,ranged from 410 to 1 874.The hospitals located in province capital were more efficient than those located in the prefecture-level and county-level cities.There were 48 units in constant returns to scale.Conclusion： Only a minority（36.4%） of units had economies of scale.Most tertiary hospitals expanded too fast.The appropriate beds number for tertiary hospitals was from 400 to 1 800.Those located in the province capital should be limited to be under 1 800,and 1 200 beds for those located in the prefecture-level and county-level cities.