吉林省县级公立医院运行效率评价:基于DEA-Malmquist指数模型

Operational Efficiency Evaluation of County-Level Public Hospitals in Jilin:Based on DEA-Malmquist Index Model

目的:对2015—2019年吉林省42所县级公立医院的运行效率以及变化情况进行研究。方法:采用CCR-DEA、BCC-DEA以及Malmquist指数模型对样本县级公立医院的运行效率进行评价和动态分析。结果:2015—2019年样本机构的投入指标中注册护士的年平均增长率最快,为5.99%,产出指标中出院人数的年平均增长率最快,为5.22%。2015年DEA有效的医院有11家,2019年有8家。各个年度显示处于规模递减状态的医院数量最多,其中综合医院数量明显多于中医院。由于技术效率提高而带来全要素生产率提高的医院有11家,由于技术进步带来全要素生产率提高的医院17家。结论:县级公立医院整体服务效率有待改善,医院规模效率较低,全要素生产效率的提高主要得益于技术进步,因此医院应重视医务人员的素质水平,学习先进的医疗卫生技术和管理经验与方法。卫生管理部门应控制医院的盲目扩张,引导优质资源在各级医院间的共享和下沉。

Objective:The operational efficiency and its change of 42 county-level public hospitals in Jilin province from 2015 to2019 was studied.Methods:CCR-DEA,BCC-DEA and Malmquist index models were used to conduct evaluation and dynamitic analysis on the operational efficiency of county-level public hospitals.Results:From 2015 to 2019,the average annual growth rate of registered nurses was the fastest(5.65%),and the average annual growth rate of discharged persons was the fastest in the output index(5.70%).There were 11 DEA effective hospitals in 2015 and 8 DEA effective hospitals in 2019.The number of hospitals in decreasing state accounted for the majority in 42 county-level public hospitals,with more general hospitals than traditional Chinese medicine hospitals.Scale-decreasing hospitals take the majority in these years,while the amount of general hospitals are larger than the traditional Chinese medicine hospitals.There were 11 hospitals that have got improvements in total factor productivity due to increased technical efficiency,and 17 hospitals due to technological progress.Conclusion:The overall service efficiency of county-level public hospitals needs to be improved.The scale efficiency of hospital is relatively low.The improvement of total factor production efficiency mainly benefits from technological progress.Therefore,hospitals should pay attention to the quality level of medical personnel,learn advanced medical technology and management experiences.Health Administration departments should control the blind expansion of hospitals and guide the sharing and sinking of high-quality resources among hospitals at all levels.