新医改背景下宁夏二级及以上医院效率的Malmquist指数研究

Malmquist Index Study on the Efficiency of the Second-class and above Hospitals in New Medical and Health System Reform in Ningxia

目的分析宁夏二级及以上医院新医疗卫生改革以来的运行效率状况,为宁夏二级及以上医院的改革与发展提供建议。方法收集2014-2016年宁夏50家二级及以上医院经济运行面板数据,利用数据包络分析方法中的Malmquist模型分析医院运行效率变化情况。结果 3年间样本医院投入和产出均有所增长,2016年院均固定资产增长最多,相比2015年增长了20.47%;2015年和2016年的院均总收入和院均总支出增长量也相对较大,最少增长了9.9%,最多增长了13.9%。但2014-2015年和2015-2016年间的全要素生产率指数均小于1,医院的总体运行效率仍有待进一步提高。2014-2016年,三级医院全要素生产率增长了5.6%,二级医院全要素生产率下降了5.3%,三级医院运行效率要高于二级医院;三级医院中,中医医院全要素生产率上升2.9%,综合医院全要素生产率上升1.4%;二级医院中,中医医院全要素生产率下降3.9%,综合医院全要素生产率下降6.0%,综合医院与中医医院运行效率相近。结论宁夏二级及以上医院需从医疗技术创新、加强医院管理和合理配置投入等要素方面入手,逐步改善医院运行现状,最终达到提高医院运行效率的目标。

Objective To analyze the operating efficiency of second-class and above hospitals since the reform of medical and health system in Ningxia, and provides suggestions for the reform and development of hospitals. Methods The panel data of the economic operation of 50 second-class and above hospitals in Ningxia from 2014 to 2016 were collected and the operating efficiency of the hospital was analyzed by Malmquist model. Results In the past three years, the input and output of the sample hospitals were increasing. In 2016, the average fixed assets of the hospitals grew- the most, an increase of 20.47% over 2015. In 2015 and 2016, the increase in the average total income and the average total expenditure of the hospitals was also relatively large, with a minimum increase of 9.9% and a maximum increase of 13.9%. However,the total factor productivity index in 2014-2015 and 2015-2016 was all less than 1, and the overall operating efficiency of the hospital still needs to be further improved. From 2014 to 2016, total factor productivity of tertiary hospitals increased by 5.6% , total factor productivity of secondary hospitals decreased by 5.3% ,and operation efficiency of tertiary hospitals was higher than that of secondary hospitals. The operating efficiency of the general hospitals and the Chinese medicine hospitals were as the same.Among the tertiary hospitals, the total factor productivity of traditional Chinese medicine hospitals increased by 2.9 percent and that of general hospitals increased by 1.4 percent.In secondary hospitals, the total factor productivity of traditional Chinese medicine hospitals decreased by 3.9% ,that of general hospital decreased by 6.0% ,and that of general hospital and traditional Chinese medicine hospital were similar in operating efficiency. Conclusion The second-class and above hospitals in Ningxia should start with the medical technology innovation, strengthen the hospital management and rational allocation of input elements, and gradually improve the hospital operation status, and ultimately achieve the goal of improving hospital operation efficiency.