基于DEA-BCC模型的临床科室医疗服务效率分析

Analysis of medical service efficiency of clinical departments based on data envelopment analysis-BCC model

目的分析临床科室的医疗服务产出效率,为医院合理配置资源和提高服务效率提供切入点。方法运用数据包络分析(DEA)的经典BCC模型对某院44个临床科室的医疗服务效率进行评价,分析其综合效率、纯技术效率、规模效率和规模收益。投入指标分别为医护人员数量、医疗成本、期末实有床位数,产出指标为疾病诊断相关分组(DRG)指标,包括DRG组数、总权重、病例组合指数、费用消耗指数、时间消耗指数和中低风险组死亡率。结果2018年全院的综合效率、纯技术效率、规模效率平均值分别为0.897、0.920和0.975,DEA相对有效科室16个(占36%),弱有效科室7个(占16%),非有效科室21个(占48%)。在产出不变的情况下,非DEA有效科室期末实有床位、医护人员、医疗业务支出的冗余率分别为17.3%、20.3%和17.1%;在投入不变的情况下,非DEA有效科室均存在产出不足情况。结论该医院医疗服务综合效率较为理想,但非DEA有效科室占比较高,建议通过优化资源投入、强化学科建设、加强成本管控等方式提升医疗服务效率。

Objective To analyze the output efficiency of medical services in clinical departments,so as to provide a breakthrough point for rational allocation of resources and improvement of service efficiency.Methods The classic BCC model of data envelopment analysis(DEA)was used to evaluate the medical service efficiency of 44 clinical departments in a hospital,and the comprehensive efficiency,pure technical efficiency,scale efficiency and scale benefits were analyzed.The input indicators were the number of medical staff,medical costs and the number of beds at the end of the period.The output indicators were diagnosis-related group(DRG)indicators,including the number of DRG groups,total weight,case mix index,cost consumption index,time consumption index and mortality rate of low-risk group.Results The average values of comprehensive efficiency,pure technical efficiency and scale efficiency of the whole hospital in 2018 were 0.897,0.920 and 0.975 respectively.DEA was relatively effective in 16 departments(36%),weakly effective in 7 departments(16%),and ineffective in 21 departments(48%).In the case of constant output,the redundancy rates of the actual beds,medical staff and medical business expenditure of non DEA effective departments were 17.3%,20.3%and 17.1%respectively;under the same input,the output of non DEA effective departments was insufficient.Conclusions The comprehensive efficiency of medical services in this hospital is ideal,but the proportion of non DEA effective departments is relatively high.It is suggested to improve the efficiency of medical services by optimizing resource input,strengthening discipline construction,and strengthening cost control.