基于网络DEA模型的天津市社区卫生服务中心公共卫生服务效率分析与评价

Analysis and evaluation of public health service efficiency of community health service centers in Tianjin based on network DEA model

目的分析和评价天津市社区卫生服务中心公共卫生服务效率,为提高公共卫生服务效率,促进基本卫生服务均等化提供科学依据。方法于2018年3—5月采用整群随机抽样法从天津市16个区每个区抽取4家社区卫生服务中心,最终共选取64家社区卫生服务中心作为分析样本。采用社区卫生服务中心公共卫生服务投入产出调查表,调查表主要内容包括社区卫生服务机构基本公共卫生服务经费、公共卫生服务人员数、执业医师数、慢性病防控设备种类数、高血压和糖尿病患者建档人数、健康知识讲座次数、儿童健康系统管理人数和孕产妇产前健康管理人数等方面。采用MAXDEA 6.9软件的网络DEA模型,分析2017年天津市社区卫生服务中心的公共卫生服务效率。结果64家社区卫生服务中心有6家达到有效,在58家网络DEA无效机构中,节点1效率得分高于节点2的机构总数为53家,占91.4%,其中节点1效率值最高为滨海新区(0.947),最低为南开区(0.641),节点2效率值最高为河西区(0.811),最低为南开区(0.507)。结论天津市社区卫生服务中心的公共卫生服务效率较低,多数社区卫生服务中心将卫生财力转化为卫生人力、物力资源的效率较高,各区的公共卫生服务效率差异较大。

Objective To analyze and evaluate the efficiency of public health services in Tianjin community health service centers,and to provide the scientific evidence for improving the efficiency of public health services and promoting the equalization of basic health services.Methods From March to May of 2018,the cluster random sampling method was used to select 64 community health service centers from 16 districts of Tianjin as the samples.The questionnaire about input and output of public health service in community health service centers was used to investigate the funds,number of assignments,number of practicing doctors,types of chronic disease prevention and control equipments,number of people with hypertension and diabetes on file,lectures on health knowledge,number of children in child health system,number of pregnant women in pre partum health management in community health service center.Network DEA model was used to analyze the public health service efficiency of 64 community health service centers of Tianjin in 2017.The used software was MAXDEA 6.9.Results In 64 community health service centers,6 centers were effective,58 centers were not effective;among the ineffective centers,53 centers’scores in node 1 were higher than those in node 2(91.4%).The center with the highest node 1 efficiency was Binhai new district(0.947),the center with the lowest node 1 efficiency was Nankai district(0.641);the center with the highest node 2 efficiency was Hexi district(0.811),the center with the lowest node 2 efficiency was Nankai district(0.507).Conclusion The efficiency of public health services in Tianjin community health service centers was lower,most of the community health service centers had higher efficiency in transforming health financial resources into health manpower and material resources,and the efficiency of public health services in these districts was quite different.