基于数据包络分析的珠海市社区卫生服务机构基本公共卫生服务项目效率评价

Efficiency evaluation of basic public health service projects of community health service organizations in Zhuhai city based on data envelopment analysis

目的评价珠海市社区卫生服务机构基本公共卫生服务效率,为制定基本公共卫生相关政策策略提供参考。方法以珠海市23家街道/镇级医疗卫生机构为研究对象,应用数据包络分析(DEA)方法计算各机构2017年度基本公共卫生服务项目的综合效率、纯技术效率和规模效率值并进行评价分析。结果23家机构中8家机构基本公共卫生服务项目DEA综合效率得分为1.0分,占43.8%;综合效率得分低于1.0分的15家机构中,6家是由于规模效率得分低于1.0分,另外9家纯技术效率和规模效率同时低于1.0分;12家处于规模收益递减阶段,3家处于规模收益递增阶段。中心城区社区医疗卫生机构基本公共卫生服务项目DEA得分高于远城区(P<0.05),中心城区综合效率得分低于1.0分主要是因为规模效率得分低,远城区则同时存在纯技术效率和规模效率偏低的情况。结论珠海市社区卫生服务机构基本公共卫生服务项目效率还存在提升的空间,应该针对不同片区、不同机构存在的不同问题进行分类施策,针对性地解决其存在的问题。

Objective To evaluate the efficiency of basic public health service projects of community health service organizations in Zhuhai city,and provide reference for basic public health related policy strategies making.Methods A total of 23 street/community health organizations in Zhuhai city were selected as research objects.The comprehensive efficiency,pure technical efficiency and scale efficiency of the 2017 basic public health service projects were calculated and evaluated by data envelopment analysis(DEA)method.Results There were 8 community health service organizations whose DEA comprehensive efficiency score reached 1.0 among the 23 organizations,which accounting for 43.8%.Of the 15 organizations whose DEA comprehensive efficiency scores below 1.0,6 organizations were due to a lower scale efficiency score,and another 9 organizations were due to both lower pure technical efficiency and lower scale efficiency score;12 organizations were in scale returns decreasing-stage,and 3 organizations were in scale returns increasing-stage.The DEA scores of the basic public health service projects of community health service organizations in the central city were higher than those in the remote city(P<0.05).Those organizations in the central city had lower comprehensive efficiency scores were all due to the lower scale efficiency score,on the contrast,the lower DEA comprehensive efficiency scores of the centers in remote city were due to the lower technical efficiency and the low scale efficiency score.Conclusion There is still room for the improvement of the efficiency of basic public health service projects in community health service organizations in Zhuhai city,and the classification policies or strategies should be carried out for different problems in different regions and different institutions,to solve the problems in the very targeted centers.