三医联动改革前后三明市县级公立综合医院与中医院的综合效益评价

The comprehensive efficiency evaluation of the county public general hospitals and traditional Chinese medicine hospitals of Sanming City before and after the Joint Reformation for Public Health Services,Medical Insurance,and Medical Production-Circulation

目的:评价和比较三医联动改革前后三明市县级公立综合医院和中医院的综合效益,为进一步深化改革提供理论依据。方法:应用TOPSIS模型对参与改革的综合医院和中医院改革前一年、改革当年、改革后一年和改革后两年的综合效益进行评价。结果:综合医院改革前后的Ci值分别为0.07、0.19、0.60、0.74,中医院改革前后的Ci值分别为0.00、0.19、0.51、1.00。结论:改革后,综合医院和中医院的综合效益均有明显提升,但改革对二者的影响是不同的。综合医院改革后一年效果明显,但仍有进一步提升的空间;中医院则在改革后两年达到最优效益。建议对现有医改制度进行顶层设计时,加大对综合医院的改革力度,逐步探索不同性质、不同类别医院的长效改革路径,助力分级诊疗的实施,切实解决好群众看病难、看病贵问题。

Objective： To evaluate and compare the comprehensive efficiency of the county public general hospitals and traditional Chinese medicine hospitals of Sanming City before and after the Joint Reformation for Public Health Services, Medical Insurance, and Medical Production-Circulation, so as to provide theoretical reference for the further deepening of the health reform. Methods ： TOPSIS model was used to evaluate the comprehensive efficiency of the hospitals one year before the reform, in the reform year, one year after the reform and two years after the reform. Results： Ct values of general hospitals before and after the reform were 0.07, 0.19, 0.60 and 0.74; those of traditional Chinese medicine hospitals were 0.00, 0.19, 0.51 and 1.00. Conclusion： The health reform has significantly improved the comprehensive efficiency of both types of hospitals, while the influences were different between the two types. The comprehensive efficiency of general hospitals boosted one year after the reform and could be further enhanced; that of traditional Chinese medicine hospitals achieved the highest values two years after the reform. It is suggested to intensify the reform of general hospitals and explore the long-term reform paths for different types of hospitals, so as to implement hierarchical medical system and solve the problem of the unreachable and expensive medical services.