湖北省乡镇卫生院效率分析

Efficiency analysis of township hospitals in Hubei

目的 :通过对湖北省乡镇卫生院的效率进行分析和评价,为乡镇卫生院投入产出指标选择和合理配置农村卫生资源提供信息支持。方法 :采用聚类分析和数据包络方法,分别从湖北东部、中部、西南部和西北部抽取180家中心乡镇卫生院进行分析。结果 :分析得出包含质量、医疗服务和公共卫生服务的产出指标体系;纯技术效率完全有效的乡镇卫生院有101家(56.11%),规模报酬不变的乡镇卫生院45家(25.00%),技术效率完全有效的乡镇卫生院45家(25.00%);湖北西北部地区效率最高,湖北东部地区冗余严重,西南和中部地区差异大;湖北乡镇卫生院总体纯技术有效和规模效率的得分较高,技术效率得分较低,各效率分布有呈现倒三角。结论 :建议加强对湖北东部地区的卫生资源优化,协调湖北西南和中部地区的投入和地区差异,控制资源冗余的乡镇卫生院的规模和加大资源短缺地区的投入,加强乡镇卫生院的内涵建设。

Objective： To analyze and evaluate the efficiency of township hospitals in rural Hubei for supporting rational input-output indicators of these institutes and provide information support for rational allocation of health resources in rural areas. Methods： A cluster analysis and data envelope analysis（ DEA ） were used to analyze 180 center township hospitals which were extracted from the eastern, central, southwestern and northwestern Hubei. Results： An indicator system including quality, output of medical services and public health services was established. There were 101 （ 56.11% ） township hospitals whose pure technical efficiency were perfectly valid, 45 （ 25.00% ） township hospitals constantly returned to scale. There were 45 （ 25.00% ） township hospitals whose technical efficiency were perfectly valid. The efficient scores in northwestern Hubei were highest among the four regions. Serious redundancy was found in eastern Hubei, and large regional and internal differences were found between southwest and central regions. Overall, pure technical efficiency and scale efficiency scores of township hospitals in Hubei were high. Technical efficiency scores were relatively low. Distribution of different levels of efficiency were an inverted triangle. Conclusion： It is suggested to strengthen health resource optimization of eastern Hubei, coordinate regional differences among different regions of Hubei, control scale of resources redundant township hospitals and increase investment in the regions short of resources. It is also suggested to strengthen the connotation construction of township hospitals.