应用数据包络分析方法评价肿瘤专科医院临床科室综合效益

Comprehensive Benefits Evaluation of Clinical Departments in Oncology-special Hospital by Data Envelopment Analysis

[目的]建立肿瘤专科医院临床科室综合效益评价指标体系,为提升临床科室医疗资源利用效率和管理水平提供参考。[方法]应用文献研究和专家咨询的形式评估各类成本在科室所占比例。用线性回归分析人力成本、医疗成本、药品成本、管理保障成本和固定资产折旧这5类成本对总收入的影响。数据包络分析方法进行临床科室的规模效益分析。[结果]5类成本中,药品成本在各临床科室所占比重最大,各科室成本回收率均>1,说明各科室收入均大于成本。其中F科室成本回收率高于其他临床科室。线性回归分析表明5类成本对总收入的影响决定系数为0.972(F=203.258,P<0.001),影响力从大到小的3类成本依次为人力成本、医疗成本和药品成本,三者对总收入的影响均有统计学意义。科室A和C相对效率最优,科室G相对效率最低。科室D、F和G规模较大,但效益偏差。[结论]医院临床科室成本效益评价体系中药品成本所占比重最大,应作为成本要素管理的重点。部分临床科室存在投入过剩或产出不足现象,且规模较大、效益差,需缩小其规模、减少投入。

Purpose To establish the evaluating indicators’ system of comprehensive benefits for clinical departments in oncology-special hospital,in order to provide the reference for utilization efficiency of clinical resource and management level.Methods Literature analysis and experts consulting was used to assess the percentage of various costs in each department. The linear regression was applied to explore the impact of human resource/equipment material/drugs/management costs and depreciation of fixed assets on the annual income.Benefit efficiency was calculated by the Data Envelopment Analysis （DEA）. Results Drugs costs accounted the largest proportion of the five costs. The cost recovery rates of the seven clinical departments present the phenomenon of total revenue was more than the costs,with the figure was more than 1.The cost recovery rate of Dep.F was far more than the others.The coefficient of determination was 0.972（F=203.258,P0.001）. Human costs, equipment material costs and drugs costs made up the most proportion . Dept.A and C had optimal efficiency of all the departments.Dept.G had a relatively lower benefits. Dept.D,E and F had a larger scale,but with the lowest benefits. Conclusion The cost of drugs should be the key point of management.Investment phenomenon of surplus or insufficient output exists in partial clinical departments. The scale of some clinical departments should be diminished and input be reduced.