基于三阶段DEA模型的我国中医医院与中西医结合医院运行效率比较

Comparison of Operating Efficiency Between China's TCM Hospitals and Integrated Chinese and Western Medicine hospitals Based on the Three-stage DEA Model

目的:对2017年全国30个省(直辖市、自治区)中医医院和中西医结合医院运行效率进行比较分析,以期为我国中医药卫生资源合理配置提供参考。方法:运用三阶段DEA模型,在剔除人口密度、地区生产总值、总抚养比、病死率以及中医机构财政拨款和随机干扰的基础上,分析并比较我国中医医院和中西医结合医院的技术效率、纯技术效率和规模效率。结果:经三阶段DEA分析,我国中医医院和中西医结合医院的技术效率、纯技术效率和规模效率分别为0.870、0.911、0.957和0.733、0.900、0.823。调整后各地区中医医院均值排序为:西南(0.970)>华中(0.951)>华东(0.933)>华南(0.901)>西北(0.880)>华北(0.725)>东北(0.686)。中西医结合医院的地区排序为:西南(0.872)>华中(0.852)>华东(0.808)>华北(0.687)>华南(0.676)>东北(0.609)>西北(0.603)。结论:一阶段DEA结果和三阶段DEA结果存在显著差异,本文所选取的环境变量对中医医院和中西医结合医院的运行效率影响较大。中医医院运行效率整体高于中西医结合医院。

Objective: To measure the operating efficiency of 30 provinces’ TCM hospitals and integrated Chinese and Western medicine hospitals in 2017, to provide reference for the rational allocation of TCM health resources in China. Methods: The three-stage DEA model was used to evaluate the technical efficiency, pure technical efficiency and scale efficiency of TCM hospitals and integrated Chinese and Western medicine hospitals on the basis of excluding population density, gross regional product, total dependency ratio, case fatality rate, financial allocation and random interference of Chinese traditional medicine institutions. Results: In the three stage, the TE, PTE and SE of TCM hospitals and integrated Chinese and Western medicine hospitals were 0.870, 0.911, 0.957 and 0.733, 0.900, 0.823, respectively. For TCM hospitals, the TE of each religion was ranked as follows: Southwest China(0.970) > Central China(0.951) > East China(0.933) > South China(0.901) > Northwest China(0.880) >North China(0.687) > Northeast China(0.686), and for integrated Chinese and Western medicine hospitals, Southwest China(0.872) > Central China(0.852) > East China(0.808) > North China(0.687) > South China(0.676) > Northeast China(0.609) > Northwest China(0.603). Conclusion: There was a significant difference between the TE measured by the traditional DEA model and the three-stage DEA model. The environmental factors selected in the paper had great influence on the efficiency of TCM hospitals and integrated Chinese and Western medicine hospitals. Overall, the efficiency of TCM hospitals was higher than integrated Chinese and Western medicine hospitals.