山东省县级公立中医院医疗服务效率变化趋势分析——基于DEA-Malquist指数模型

Study on the trend of medical service efficiency of county-level Chinese traditional public hospitals in Shandong Province——Based on DEA-Malmquist index model

[目的]通过分析当前县域内中医院的动态效率及其收敛性,为县级公立中医院服务能力的提升和协调发展提供科学的参考依据。[方法]采用DEA分析进行效率评价,采用σ收敛分析、绝对β收敛与条件β收敛3种方式对全要素生产率(TFP)变动收敛情况进行检验。[结果]山东省县级公立中医院全要素平均增长率为3.5%,且其变动方向与技术进步的变动方向一致。2006-2012年,中医院的TFP指数不存在明显σ收敛和β收敛,但存在条件收敛。[结论]山东省县级公立中医院的TFP呈增长趋势,技术进步是促进其增长的主要因素,在不考虑其他任何条件下,中医院间的TFP差距会随着时间的推移逐渐拉大,且不断扩大医院规模的发展理念对于减少医院TFP的差异来说作用不大,但如果弱化经济因素对中医院的影响有利于促进全省中医院的均衡发展。建议中医院转变投入型的粗放式增长模式,对现有的卫生资源进行深度协调,促进管理水平和医疗技术水的双重提升,实现内涵式增长,同时政府进一步完善卫生财政分配制度,加强对经济欠发达地区的经济扶持。

Objective Through analyzing current dynamic efficiency and its astringency so as to provide scientific reference basis for promoting service ability and coordinating development in county-level public hospitals.Methods It used DEA analysis to conduct efficiency rating,and tested variable convergence of total factor productivity(TFP)by three styles ofσconvergence analysis,βabsolute convergence and conditionβconvergence.Results Average increase rate of total factor in county-level public hospitals of Shandong province was 3.5%.It was accordance of variable direction and technical progress.From 2006 to 2012,there was no obviousσandβconvergence in TEP index,but it had condition convergence.Conclusions TEP of county-level public hospitals of Shandong province shows uptrend.Technical progress is main factor of promoting its increase.The TEP difference is gradually widened as time goes on in different hospitals under taking no account of other conditions.It has no more effect of that the development idea of continuous expansion of hospital scale could not decrease TEP difference of hospitals.However,it is in favour of promoting balanced development of provincial TCM hospital if weakens the influence of economic factor in TCM hospital.It suggests that TCM hospital should change the extensive growth mode of input type,depth coordination on current health resource,promote both improvement of management level and medical service technique,carry out connotative increase.Government should further improvement of health financial distribution system,and strengthen economic support for economic less-developed region.