生产技术异质性视角下重庆市三级公立医院运营效率分析

Analysis of operational efficiency of third level public hospitals in Chongqing from the perspective of technical heterogeneity

目的比较分析重庆市不同类型三级公立医院运营效率,并测算效率损失程度及探索效率损失根源。方法利用重庆市2012—2014年医疗机构主要指标汇编数据,运用非参数共同方法进行分析。结果重庆市三级公立医院运营效率在共同前沿和组别前沿条件下得分均值分别为0.763和0.854,不同类型三级公立医院运营效率得分大小顺序为中医院>综合医院>专科医院。重庆市三级公立医院技术落差比率均值为0.894,不同类型三级公立医院技术落差比率大小顺序为综合医院>中医院>专科医院。重庆市三级公立医院运营无效率得分均值为0.237,不同类型三级公立医院运营无效率得分大小顺序为专科医院>综合医院>中医院。重庆市三级公立医院技术无效率和管理无效率的贡献度分别为38.20和63.80;综合医院为39.09和60.91,中医院为67.68和32.32,专科医院为25.64和74.36。结论重庆市三级公立医院明显存在技术异质性特征,并且不同类型三级公立医院技术异质性表现程度存在显著差异;不同类型三级公立医院效率损失根源存在显著差异,综合医院和专科医院效率缺失主要受制于落后的管理水平,中医院主要来源于落后的生产技术水平。

Objective To compare and analyze the operational efficiency of different types of third level public hospitals in Chongqing, estimate the degree of efficiency loss, and explore the causes of efficiency loss. Methods Data on major indexes of health care institutions in Chongqing from 2012 to 2014 were collected and analyzed by the non-parametric meta-frontier method. Results The average operational efficiency scores of third level public hospitals in Chongqing for meta-frontier and group-frontier were 0. 763 and 0. 854, respectively. The average operational efficiency score of Traditional Chinese Medicine （TCM） hospitals was the highest, followed by comprehensive hospitals and specialized hospitals. The average technique gap ratio of third level public hospitals in Chongqing was 0. 894. The average technique gap ratio of comprehensive hospitals was the highest, followed by TCM hospitals and specialized hospitals~ The average operational inefficiency score of third level public hospitals in Chongqing was 0. 237. The average operational inefficiency score of specialized hospitals was the highest, followed by comprehensive hospitals and TCM hospitals. The contributions oftechnique gap inefficiency and management inefficiency in third level public hospitals in Chongqing were 38.20 and 63.80, those of comprehensive hospitals, TCM hospitals, and specialized hospitals were 38.20 and 63.80, 39.09 and 60.91, 67.68 and 32.32, and 25.64 and 74.36, respectively. Conclusion Third level public hospitals in Chongqing have significant technical heterogeneity and the technical heterogeneity in different types of third level public hospitals is significantly different. The causes of efficiency loss in different types of third level public hospitals are remarkably different. For comprehensive hospitals and specialized hospitals, the efficiency loss is mainly due to backward management level. While for TCM hospitals, the efficiency loss is mainly caused by backward technique level.