基本药物制度实施前后山东省乡镇卫生院医疗服务效率评价

Evaluation of medical service efficiency before and since the implementation of the essential medicine system at township hospitals in Shandong province

目的：对山东省乡镇卫生院的医疗服务效率进行评价,为基本药物制度背景下乡镇卫生院的发展提供参考。方法使用数据包络分析法（data envelopment analysis,DEA）对基本药物制度实施前、后山东省15所乡镇卫生院医疗服务效率变化进行评价分析。结果从总体上看,基本药物制度实施后,山东省乡镇卫生院医疗服务效率的相对有效比例从66.67%下降到53.33%；从投入和产出上看,基本药物制度实施后,非 DEA 有效的乡镇卫生院在产出指标上均存在产出不足的情况,而个别投入指标则投入过多。结论基本药物制度实施后,规模效率不高成为影响山东省乡镇卫生院医疗服务效率的主要因素。建议继续完善基本药物制度,提高医务人员的工作积极性,改善财政补偿政策,保持政策的延续性。

Objective To evaluate the township hospitals＆#39;medical service efficiency in Shandong province,and to provide references for the development in township hospitals under the background of the essential medicine system.Methods The method of data envelopment analysis（DEA）was used to analyze the township hospitals＆#39; medical service efficiency in Shandong province before and since the implementation of the essential medicine system.Results For the township hospitals in Shandong province in general,their relative efficiency ratio of the medical service efficiency dropped from 66.67% to 53.33% since the implementation of the essential medicine system.In terms of the input and output,the non-DEA effective township hospitals are found with insufficient output as measured by the output indicator,while some input indicators input were found as excessive.Conclusion The low scale efficiency has become the main factor for the low service efficiency of such hospitals since the implementation of the essential medicine system in Shandong province.In order to improve the medical service efficiency,it is important to continue to improve the essential medicine system,increase the medical staff＆#39;s incentives, improve the fiscal compensation policy,and keep the policy continuity.