基于数据包络分析的2018年我国中医类医院服务效率评价

Study on the Service Efficiency of Traditional Chinese Medicine Hospitals in 2018 Based on Data Envelopment Analysis

目的:对2018年全国各省、市、自治区中医类医院服务效率进行整体评价,为实现中医类医院卫生资源优化配置提出建议。方法:结合数据包络分析(DEA)中的CCR模型与BCC模型对我国30个省、直辖市、自治区及按地理区域划分的华北、东北、华中、华东、华南、西南、西北7个区域中医类医院进行综合效率、单纯技术效率、规模效率及规模报酬评价,对非DEA有效省份投入产出进行投影分析。结果:全国累计3个(10.00%)省份实现综合效率相对有效发展,13个(43.33%)轻度无效发展,14个(46.67%)中度无效发展,总体中医类医院投入产出均衡性较弱。13个省份(43.33%)的单纯技术效率值为1,现有资源投入和产出效率仍存在较大提升空间。27个省份中医类医院规模均未达到最优,整体规模报酬以递减为主。东北地区和西北地区的总体效率处于中度无效,与其他区域中医类医院效率水平差距较大。结论:我国中医类医院效率总体偏低,应加强中医药卫生资源规划及医院内部管理;省际、区域之间发展不平衡,东北地区和西北地区改善空间较大;总体医院规模效益递减,应合理调整中医类医院资源投入方向。

Objective: To evaluate the service efficiency of traditional Chinese medicine(TCM) hospital in all provinces, municipalities and autonomous regions in 2018, and make recommendations for the optimization of the allocation of health resources in TCM hospitals. Methods: Combined with CCR and BCC model in data envelopment analysis(DEA), the comprehensive efficiency, simple technical efficiency, scale efficiency and scale reward of TCM hospitals in 30 provinces, municipalities and autonomous regions and 7 regions of North China,Northeast China, Central China, East China, South China, Southwest and Northwest divided by geographical region were evaluated, and made projection analysis of input-output of non DEA effective provinces. Results: A total of 3 provinces(10.00%) achieved relatively effective development of comprehensive efficiency, 13(43.33%)slightly ineffective development and 14(46.67%) moderately ineffective development. The overall input-output balance of TCM hospitals was weak. The pure technical efficiency value of 13 provinces(43.33%) was 1, and there was still much room for improvement in the input and output efficiency of existing resources. The scale of traditional Chinese medicine hospitals in 27 provinces had not reached the optimal level, and the overall scale return was mainly decreasing. The overall efficiency of Northeast China and Northwest China was moderately ineffective, and there was a large gap with the efficiency level of traditional Chinese medicine hospitals in other regions. Conclusion: The overall efficiency of TCM hospitals in China was generally low. It was necessary to strengthen the planning of TCM health resources and internal management of hospitals. The development between provinces and regions was unbalanced, and the Northeast and Northwest regions had large room for improvement.The overall hospital scale benefit was decreasing, so the direction of resource investment in TCM hospitals should be adjusted reasonably.