不同类型养老机构资源配置效率的调查研究

Difference in the Efficiency of Resource Allocation in Different Types of Nursing Settings for the Aged

目的：调查养老机构资源配置状况，对不同类型养老机构资源配置的效率及规模报酬进行比较。方法采用多阶段分层抽样方法，于2014年3月—2015年9月对济南市和青岛市126家养老机构负责人进行面对面现场问卷调查。采用自行设计调查问卷进行调查，包括基本情况、投入情况、产出情况。基本情况包括养老机构所处地点、类型等；投入指标包括养老机构的开放床位数、护理人员数、业务投入、固定资产；产出指标包括入住人数、半自理及不能自理人数、业务收入。利用 DEAP 2.1软件进行数据包络分析（DEA），包括相对有效性投入指标、产出指标；资源配置效率调整分析；资源配置规模报酬分布情况。结果126份调查问卷中回收118份，回收率为93.7％，其中有效问卷107份，有效回收率为84.9％。养老机构处于济南市46家，青岛市61家；公立养老机构50家（46.7％），私立养老机构57家（53.3％）。107家养老机构的资源配置总有效率为48.6％（52/107）。公立与私立养老机构相对有效性护理人员数、业务投入有效率比较，差异均有统计学意义（P ＜0.05）；公立与私立养老机构总有效率、相对有效性开放床位数、固定资产、入住人数、半自理及不能自理人数、业务收入有效率比较，差异均无统计学意义（ P ＞0.05）。公立与私立养老机构开放床位数、护理人员数、业务投入、固定资产、半自理及不能自理人数需要调整率比较，差异均有统计学意义（P ＜0.05）；公立与私立养老机构入住人数、业务收入需要调整率比较，差异均无统计学意义（P ＞0.05）。公立与私立养老机构资源配置规模报酬分布比较，差异无统计学意义（χ2＝0.228，P ＝0.892）。结论107家养老机构的资源配置总有效率达到48.6％，投入和产出基本相匹配。在投入一定时，公立和私立养老机构均应增加半自理及不能自理的老年人数，相比而言，公立养老机构需要调整率更高。公立养老机构还应增加固定资产投入，私立养老机构还应增加业务投入和入住人数。

Objective To investigate the status of resource allocation in nursing settings for the aged and compare the efficiency and returns to scale in different types of nursing settings for the aged. Methods From March 2014 to September 2015, we undertook on - site face - to - face questionnaire survey on the persons in charge of 126 nursing settings for the aged of Ji＇nan and Qingdao by multi - staged stratified sampling method. A self - designed questionnaire was used,and the content included basic information,input and output. The basic information included the location and type of a setting;input indexes included the number of beds available,the number of nursing staff,investment and fixed assets;output indexes included the number of elders admitted,the numbers of elders who had partial self - care ability and elders who totally lost self - care ability and income. DEAP 2. 1 software was used to undertake data envelopment analysis（ DEA） including input indexes and output indexes with relative effectiveness,the analysis of efficiency adjustment of resource allocation and the distribution of returns to scales of resource allocation. Results A total of 126 questionnaires were distributed,and 118 questionnaires were returned with a recovery rate of 93. 7% . There were 107 questionnaires with an effective recovery rate of 84. 9% . Among the nursing settings,＆amp;nbsp;46 were located in Ji＇nan,and 61 were located in Qingdao;50（46. 7% ） were public - owned nursing settings for the aged, and 57（53. 3% ）were private - owned nursing settings for the aged. The total effective rate of resource allocation of the 107 nursing settings for the aged reached 48. 6% （52 / 107）. Public - owned and private - owned nursing settings for the aged were significantly different in the efficiency rates of the number of nursing staff and investment with relative effectiveness（P 〈 0. 05）;public - owned and private - owned nursing settings for the aged were not significantly different in the total effective rate,effective rates of the number of beds available,fixed assets,the number of elders admitted,the numbers of elders who had partial self -care ability and elders who totally lost self - care ability and income with relative effectiveness（P 〉 0. 05）. Public - owned and private - owned nursing settings for the aged were significantly different in the adjustment rates of the number of beds available, the number of nursing staff,investment,fixed assets,the numbers of elders who had partial self - care ability and elders who totally lost self - care ability（P 〈 0. 05）;public - owned and private - owned nursing settings for the aged were not significantly different in the adjustment rates of the number of elders admitted and income（P 〉 0. 05）. Public - owned and private - owned nursing settings for the aged were not significantly different in the distribution of returns to scales of resource allocation（ χ2= 0. 228,P = 0. 892）. Conclusion The total effective rate of resource allocation of the 107 nursing settings for the aged reached 48. 6% ,input basically matching output. When input is definite,public - owned and private - owned nursing settings for the aged should increase the admission of elders who have partial self - care ability and elders who totally lose self - care ability. By comparison,public - owned nursing settings for the aged have higher adjustment rate. Public - owned nursing settings for the aged should increase fixed assets,and private - owned nursing settings for the aged should increase investment and the number of elders admitted.