山东省县级公立医院动态效率DEA-Malmquist指数分析

Dynamic efficiency of county public hospitals in Shandong province: a data envelopment analysis- Malquist index approach

目的评价与解析山东省县级公立医院新医改前后(2006—2012)的效率动态变化情况。方法采用DEA-Malmqusit指数模型,分析山东省两类共227所县级公立医院新医改前后全要素生产率及其分解项的变化情况。结果新医改前后,山东省县级公立医院中,82.38%(187/227)可以实现全要素生产率提高,但是主要通过技术进步来实现;59.91%(91/227)的医院技术效率未得到提高,其中综合医院有52.71%(68/129)的医院纯技术效率提高,但是规模效率低下,而县级公立中医院中48.98%(48/98)的医院纯技术效率与规模效率均呈下降趋势。结论大部分医院全要素生产率呈现增长趋势,但存在过度依赖技术进步的问题;综合医院需适度发展规模以提高规模效率,中医院则需侧重提高纯技术效率。

Objective To analyze dynamic changes of county public hospitals＇ efficiency in Shandong province during the period between 2006 and 2012. Methods The dynamic changes in total factor productivity（ TFP） indice and its decomposition items of 227 county public hospitals in Shandong province before and after the implementation of new health care reform from 2006 through 2012 were analyzed with data envelopment analysis- M alquist index. Results After the implementation of new health care reform,82. 38% of the hospitals show ed improvement in TFP mainly because of the technical progress; how ever 59. 91% of hospitals did not improve their technical efficiency; although 52. 71% of the general hospitals achieved the improvement in pure technical efficiency,they failed to have the improvement in scale efficiency and 48. 98% of the traditional medicine hospitals show ed a decreased trend in both pure technical and scale efficiency. Conclusion The TFP show ed an increase trend in the most of the hospitals in Shandong province after the implementation of new health care reform but excessively relied on technical progress,suggesting developments in rational scale for general hospitals and medical technology for traditional Chinese medicine hospitals are warranted for further TFP improvement.