基于DEA-Tobit模型的江苏省三级医院运行效率研究

Study on the Efficiency of Tertiary Hospitals in Jiangsu Based on the DEA-Tobit model

目的:评价2017年江苏省58所三级甲等医疗机构运行的相对效率,分析大型医疗机构运行现况,并基于优化医疗资源配置,推动大型三级医院合理运转的角度提出建议。方法:通过数据包络分析法对三级甲等医疗机构的技术效率和规模效率进行比较研究,并利用Tobit模型探索效率的影响因素。结果:江苏省58所三级甲等医院的综合效率相对较低,仅17.24%的医院DEA有效,机构运行效率存在地区差异,苏南地区存在医疗资源投入冗余,苏中地区资源投入不足。医院卫生技术人员总数、人员床位比、平均住院日与医护比影响机构运行效率。结论:结合区域医疗机构运行现况,从省级纵观层面上合理规划医疗资源配置,积极引导大型三级甲等医院内涵发展,不断提高机构管理能力和资源利用率。

Objectives:To assess the relative efficiency of 58 Tertiary Hospitals in Jiangsu in 2017,which would help to put forward some suggestions considering optimizing the allocation of medical resources and promoting the rational operation of these large hospitals. Methods:Data Envelopment Analysis(DEA)was used to compare the technical efficiency and scale efficiency of 58 Tertiary Hospitals,Tobit model was employed to explore the influencing factors of efficiency. Results:The comprehensive efficiency of these hospitals were relatively low,only 17.24% in the interval of effectiveness. There are significant differences in efficiency considering different districts. Input redundancy was indeed in the southern part of Jiangsu Province while the insufficient investment in the middle part. The efficiency was influenced by the total number of health technical staffs,staff bed ratio,length of stay,and ratio of doctor and nurse. Conclusion:Regional medical resource planning should be made from the perspective of the whole province considering the operation status of hospitals. The large tertiary hospitals should focus on the connotation development,dedicated to improve the ability of management and utilization of resources.