国内医疗机构DEA模型中评价指标选择的系统评价

Systematic review on the evaluation indicator on DEA model in medical institutes in China

目的:对国内现有应用DEA模型评价医疗机构运营效率的文献进行检索,对评价指标的使用情况进行系统评价,以期为评价指标体系的构建提供借鉴。方法:按照系统评价的要求,在中国期刊全文数据库(CNKI)、万方全文数据库和维普数据库中检索1992至2012年的文献,对符合纳入标准的文献进行分析。结果:在检索到178篇文献中,纳入研究的文献共125篇,投入指标27项,总引用频次≥10次的指标有11项;产出指标18项,总引用频次≥10次的指标有10项。52.8%文献中的评价指标选择均采用了主观性很强的方法,采取较为科学的统计学方法的比例仅占41.6%。结论:医疗机构效率评价指标应结合研究目标采用科学方法进行筛选。经文献系统评价,建议使用以下评价指标:投入指标为职工总数、年总支出、固定资产总额、总床位数;产出指标为年业务收入、年出院人次(或总诊疗人次)、床位使用率。

Objectives： To systematically evaluate the existing literatures about evaluation indicator on DEA Model in general hospital in China, assess the using status of evaluation indicator in hope to offer valuable references to construction of the indicator system for DEA model. Methods： According to the requirements of systematic review, all the literatures published in the 1992-2012 among CNKI, Wan Fang and VIP Database were retrieved and analyzed all the literatures accorded with the inclusive criteria. Results： 125 literatures were matched the inclusive criteria from all 178 literatures. There were 27 input indicators, of which, 11 indictors were cited more than 10 times. 18 output indicators, of which, indictors were cited more than 10 times. 52.8% literatures use objective methods on choosing evaluating indicator, and only 41.6% literatures use statistics methods. Conclusions： The efficiency evaluation indicator in medical institutes should be scientifically chosen. According to the result of systematic review, the following indictors are considered to be chosen to assess the efficiency. The input indicator involves the total number of employee, total expenditure, fixed assets, bed numbers and the output indicator involves the revenue, discharged patients（or the total number of outpatients） and bed utility rate.