新医改背景下山东省社区卫生服务中心的卫生服务效率

Health service efficiency of community health service centers in Shandong Province in the context of new health care reform

目的评价新医改实施后山东省社区卫生服务中心的卫生服务效率。方法以床位数、卫生技术人员数为投入指标,诊疗人数、病床使用率为产出指标,采用数据包络分析的BCC模型,分析2010~2017年山东省社区卫生服务中心的卫生服务效率。结果2010~2017年,山东省社区卫生服务中心的床位数和卫生技术人员数呈上升-降低-上升的变化趋势,而诊疗人数和病床使用率逐年增加。2010年、2016年、2017年山东省社区卫生服务中心的卫生服务效率相对有效,2011年卫生服务效率弱有效;2012~2015年卫生服务效率无效,且技术效率均低于规模效率,综合效率与技术效率的变化趋势基本一致。投入-产出松弛变量分析显示,2012~2015年投入过剩和产出不足并存。结论新医改实施后山东省社区卫生服务中心存在卫生服务效率不高、规模不合理、技术效率低等现象。

Objective To evaluate the health service efficiency of community health service centers in Shandong Province after the implementation of new health care reform.Methods Using hospital bed quantity and number of health technical personnel as input indicators,number of people receiving diagnosis and treatment,and ratio of hospital bed used as output indicators,the BCC model with data envelopment analysis was applied to analyzing the health service efficiency of community health service centers in Shandong Province from 2010 to 2017.Results During 2010 to 2017,hospital bed quantity and number of health technical personnel presented a change tendency of ascending to descending to ascending in community health service centers in Shandong Province,and moreover,number of people receiving diagnosis and treatment and ratio of hospital bed used increased year by year.In 2010,2016 and 2017,the health service efficiency of Shandong community health service centers was relatively efficient,but weakly efficient in 2011;between 2012 and 2015,health service efficiency was inefficient,technical efficiency was lower than scale efficiency,and overall efficiency was basically consistent with technical efficiency in change tendency.Radial-slack movement analysis revealed that excess input and output shortage co-existed during 2012 to 2015.Conclusion The phenomena such as health service inefficiency,unreasonable scale and low technical efficiency exist in community health service centers in Shandong Province after the implementation of new health care reform.