基于DEA-BCC模型的医共体运行效率分析与对策研究

Operation Efficiency Analysis and Countermeasure Research of Medical Community Based on DEA Model

目的基于DEA-BCC模型,评价常熟市29家公立医院2014-2018年5年的运行效率,为新一轮公立医疗机构改革决策者提供数据与理论支持。方法选取常熟市29家公立医院2014-2018年的年报数据并筛选出投入产出指标,采用DEA-BCC模型分析效率与报酬状态。结果29家公立医院年均综合效率由0.841提高至0.938,纯技术效率由0.926提高至0.970,规模效率由0.905提高至0.966,DEA有效的医院由13家(44.83%)增长至16家(55.17%);规模效益递增由16家(55.17%)减少到9家(31.03%);规模效益递减由0家增加到4家(13.79%)。结论29家公立医院综合效率整体有所提升,但仍有部分医院存在资源利用不充分或过剩的问题,整体呈规模、技术提高趋势。常熟市公立医疗机构改革应将重点放在整合医疗卫生资源,实现最优投入产出;明确各级功能定位,一体化、差异化发展;加强医院内部管理,提高资源利用效率。

OBJECTIVE To provide data and theoretical support for the decision-makers of the new public medical institution reform,the operating efficiency of 29 public hospitals in Changshu from 2014 to 2018 were evaluated basing on the DEA model.METHODS Input-output indicators were selected from annual report data of 29 public hospitals in Changshu city from 2014 to 2018.DEA model was used to analyze efficiency and remuneration status.RESULTS The average annual comprehensive efficiency of 29 public hospitals increased from 0.841 to 0.938,the pure technical efficiency increased from 0.926 to 0.970,and the scale efficiency increased from 0.905 to 0.966.The effective hospitals increased from 13(44.83%)to 16(55.17%).Increasing economies of scale decreased from 16(55.17%)to 9(31.03%);Diminishing economies of scale increased from 0 to 4(13.79%).CONCLUSION The overall efficiency of 29 hospitals had been improved,however some hospitals still had the problem of insufficient or surplus utilization of resources.The reform of public medical institutions in Changshu emphasized on integrating medical and health resources to achieve optimal input and output,defining the functional positioning at all levels and develop in an integrated and differentiated way;strengthening hospital internal management,improving the efficiency of resource utilization.