基于数据包络分析的天津市滨海新区社区基本公共卫生服务资金利用效率评价

DEA- based Evaluation of Fund Utilization Efficiency of Basic Public Health Services in the Communities of Binhai New Area of Tianjin

目的评价天津市滨海新区社区基本公共卫生服务的资金利用效率,并指出存在的问题,为决策者提供建议。方法 2013年,选取滨海新区所有的14所社区卫生服务中心,包括塘沽6所社区卫生服务中心（A、B、C、D、E、F）,汉沽4所社区卫生服务中心（G、H、I、J）,大港4所社区卫生服务中心（K、L、M、N）为研究对象。研究指标包括：社区基本公共卫生服务支出、国家基本公共卫生服务补助2个投入指标和居民健康档案累计建档人数、0~6岁儿童健康管理人数、孕产妇健康管理人数、65岁以上老年人健康管理人数、高血压管理人数、糖尿病管理人数6个产出指标。采用DEAP 2.1软件包测量社区基本公共卫生服务的资金利用效率。结果 14所社区卫生服务中心基本公共卫生服务资金利用的综合效率均值为0.746,纯技术效率均值为0.934,规模效率均值为0.805。其中有6所社区卫生服务中心的数据包络分析（DEA）有效,处于规模收益不变;8所社区卫生服务中心非DEA有效,且均处于规模递减。结论天津市滨海新区社区基本公共卫生服务资金利用效率有待进一步提高。需采用科学管理理论,提高服务功能;创新经费投入机制,提高经费使用效率;规划医疗卫生布局,优化卫生资源;加强社区基本公共卫生服务考核评价,提高卫生服务效率。

Objective To evaluate the fund utilization efficiency of basic public health services in the communities of Binhai New Area of Tianjin and to find out the problems in order to provide references for policy making. Methods In 2013,we enrolled all 14 community health service centers in Binhai New Area,including 6 centers（ A、B、C、D、E、F）in Tanggu,4 centers（ G、H、I、J）in Hangu and 4 centers（ K、L、M、N）in Dagang. We examined a series of indicators,among which 2 were input indicators, including community basic public health service expenditure and national basic public health service subsidy,and 6 were output indicators,including the number of residents with health records,children aged 0 to 6 under health management,pregnant and lying - in women under health management, elderly people aged more than 65 under health management,people under hypertension management and people under diabetes management. The fund utilization efficiency of community basic public health services was evaluated using DEAP 2. 1 software package. Results The average overall efficiency, pure technical efficiency,and scale efficiency of the 14 community health service centers were 0. 746,0. 934 and 0. 805. Among the 14 community health service centers,6 centers showed effectiveness in DEA with constant returns to scale,and 8 centers showed ineffectiveness in DEA with progressive decrease in scale. Conclusion The fund utilization efficiency of basic public health services in the communities of Binhai New area of Tianjin needs further improvement. Scientific management theory should be used to promote service function,innovative fund input mechanism should be adopted to increase fund utilization efficiency, the pattern of health care should be well designed in order to make the best use of health resources,and the evaluation system of basic public health service should be promoted to increase the efficiency of health services.