基于超效率数据包络分析的我国社区卫生服务机构服务效率的评价研究

Evaluation of Service Efficiency of Community Health Service Institutions in China Based on Super-efficiency DEA

目的评价我国社区卫生服务机构的服务效率,为社区卫生服务效率的提升提供依据和建议。方法以我国各地区社区卫生服务机构相关数据为研究资料,来源于《中国卫生统计年鉴2011》。选择社区卫生服务机构数量、社区卫生服务全部人员数、社区卫生服务床位数量作为投入指标;选择社区卫生服务机构诊疗人次、入院人数、家庭卫生服务人次数、健康教育培训人次、7岁以下儿童的保健管理率作为产出指标。采用数据包络分析(DEA)法,为判断有效的决策单元效率的具体高低,建立超效率DEA(SE-DEA)模型,评价我国各地区社区卫生服务机构的服务效率。结果我国30个地区中有14个地区DEA有效,按照超效率DEA值由大到小排列依次为:上海、宁夏、广东、天津、海南、广西、福建、重庆、四川、青海、湖南、河南、贵州、浙江;剩余16个地区社区卫生服务效率为非DEA有效。从松弛变量分析,5个地区社区卫生服务机构数、2个地区社区卫生服务人员数及7个地区床位数出现利用不足情况;1个地区的家庭卫生服务人次数不足,8个地区的诊疗人次、4个地区的入院人数、12个地区的7岁以下儿童保健管理率及7个地区的健康教育培训次数有待提高。结论 2010年我国社区卫生服务效率DEA有效的地区占46.7%,30.0%的地区属于边缘有效,23.3%的地区属于DEA明显无效。因此,我国部分地区在大力推进社区卫生服务机构硬件设施建设的同时,需要加强相关配套措施的建设,提高社区卫生服务效率。

Objective To evaluate the service efficiency of community health service institutions in China and provide good references and advices for the efficiency improvement.Methods The relevant data of the community health service institutions of every area of China（ from China Health Statistical Yearbooks） were used as the research material.Select 3 input index including the institution amounts,staff number,hospital bed number and 5 output index including the number of people receiving diagnosis and treatment,inpatients number,the number of people choosing family health service,the total number of health education trainees and management rate of children under 7.DEA was used to evaluate the level of the efficient decision making units,build SE- DEA model and analyze the service efficiency of our country＇s community health service institutions.Results 14 of the 30 areas＇ DEA was effective,and according to DEA value,the sequence from big to small was Shanghai,Ningxia,Guangdong,Tianjin,Hainan,Guangxi,Fujian,Chongqing,Sichuan,Qinghai,Hunan,Henan,Guizhou and Zhejiang;the remaining 16 areas were DEA ineffective.The slack variables analysis showed that the amount of health service institutions in 5districts,personnel of community health service institutions in 2 areas and the hospital beds in 7 areas were not fully used,the number of people choosing family health service in 1 area was insufficient,8 regions＇ total visits,4 regions＇ hospitalization,12regions＇ care management rate of children under 7 years and 7 areas＇ health education training times remained to be improved.Conclusion The amount of areas of effective DEA accounts for 46.7%,30.0% of the areas＇ DEA are marginally effective,and 23.3% of the areas＇ DEA are positively invalid.Consequently,some areas need promoting the construction of necessary supplementary measures while promoting the construction of the hardware facilities of community health service institutions,in order to improve the service efficiency of community health service.