基于熵权TOPSIS法的某公立医院经济运行绩效评价研究

Performance appraisal of the business operation of a public hospital based on entropy weighted TOPSIS method

目的评估江苏省某三级甲等城市公立医院自2015年底开始城市公立医院综合改革后的经济运行绩效,为相关政策制定提供依据。方法结合公立医院现行财务和会计制度,基于文献研究选取风险管理能力、资产运营能力、收支结构管理、资产收益能力以及未来发展能力5个一级指标和14个二级指标构建城市公立医院经济运行绩效评价指标体系,采用熵权TOPSIS法评价江苏省某三级甲等城市公立医院2015年至2019年的经济运行绩效。结果收支结构管理下的二级指标药品占比、未来发展能力下的二级指标固定资产增长率和资产收益能力下的二级指标总资产报酬率是影响医院经济运行绩效的重要指标,权重分别为0.099,0.097和0.080。根据相对贴近度进行经济运行绩效排序,依次为2015年(0.515)、2016年(0.480)、2019年(0.467)、2018年(0.450)和2017年(0.356)。结论改革后江苏省某三级甲等城市公立医院的经济运行绩效出现了波动,2015年至2017年医院经济运行绩效不断下降,随着改革的深入,2018年后有所回升。建议从优化收支结构、提升资产运营能力、合理配比资产负债结构等方面提升城市公立医院经济运行绩效。

Objective To evaluate the business performance of an urban public tertiary hospital in Jiangsu province since the comprehensive reform of urban public hospitals started from the end of 2015,for reference in developing relevant policies.Methods Such level-1 indicators as risk management ability,asset operation ability,revenue and expenditure structure management,asset profitability and future development ability were selected based on literature review,along with 14 level-2 indicators,to build an operation performance appraisal indicator system for urban public hospitals.The entropy weight TOPSIS method was used to evaluate the business performance of an urban public hospital in Jiangsu province from 2015 to 2019.Results The drugs proportion(a level-2 indicator)under the revenue and expenditure structure management,the growth rate of fixed assets(a level-2 indicator)under the future development ability,and the total return(a level-2 indicator)under the asset profitability,were important ones affecting the business performance of hospitals,with the weights of 0.099,0.097 and 0.080 respectively.The business operation performance ranking as calculated by the relative closeness,was 2015(0.515),2016(0.480),2019(0.467),2018(0.450)and 2017(0.356)respectively.Conclusions The reform once resulted in fluctuations in the operation performance of this hospital,with constant declines from 2015 to 2017.With the deepening reform,its performance recovered after 2018 to some extent.It is suggested to improve the business operation performance of urban public hospitals by optimizing their income and expenditure structure,improving their asset operation ability,and matching rationally their asset liability structure,among other measures.