基于Malmquist指数的上海三级综合医院2003—2014年全要素生产率分析

Analysis of total factor productivity between 2003 and 2014 in tertiary hospitals in Shanghai based on Malmquist index

目的测量上海地区三级综合医院全要素生产率(TFP)的变动情况,为提高公立医院绩效提供评价指标和决策依据。方法收集上海市16所三级综合医院2003—2014年12年面板数据(2项投入指标,2项产出指标),应用Malmquist指数进行分析。结果 12年间样本医院TFP的年均增长率为7.2%,技术进步年均增长率为6.4%,技术效率、纯技术效率增长率均为0.8%,规模效率不变。结论上海地区三级综合医院TFP增长较缓,其增长贡献主要来源于技术进步,技术效率增长甚微;明确医院绩效改进的方向是加强内部管理,提高医疗资源的投入产出效率;还需综合运用参数、非参数法进行研究以全面评价医院绩效。

Objective To measure the changes in total factor productivity（TFP） of tertiary hospitals in Shanghai and provide assessment indexes and decision making evidence for improving the performance of public hospitals.Methods Panel data（including 2 input and 2 output indexes） between 2003 and 2014 on 16 tertiary hospitals in Shanghai were collected and analyzed with Malmquist Index.Results The annual TFP growth rate in sample hospitals in 12 years was 7.2%,the annual technical progress growth rate was 6.4%,both technical efficiency and pure technical efficiency growth rates were 0.8%,and the scale efficiency remained unchanged.Conclusion The growth of TFP in tertiary hospitals in Shanghai is slow and the main contributor is technical progress.The growth rate of technical efficiency is very low.It is clear that the improvement of hospital performance should focus on enhancing the internal management,increasing the input-output efficiency of medical care resources,as well as integration of parametric and nonparametric methods for the comprehensive assessment of hospital performance.