基于DEA-Tobit模型的广西中医类医疗机构运行效率评价及影响因素分析

Evaluation on the operational efficiency of traditional Chinese medicine medical institutions in Guangxi and analysis on its influencing factors based on DEA-Tobit model

[目的]分析评价广西中医类医疗机构的运行效率情况,为“十四五”时期推动中医药传承创新发展,提升中医药服务能力水平提供参考。[方法]采用数据包络分析方法(DEA)分别从纵向和横向2个维度对广西中医类医疗机构运行效率进行分析,并以DEA得出的效率值为因变量,建立面板Tobit模型,进一步分析广西中医类医疗机构运行效率的影响因素。[结果]纵向分析结果显示,2016-2020年广西中医类医疗机构的总体效率偏低,平均总体效率值为0.976,其中2018年、2020年为非DEA有效状态。横向分析结果显示,2020年广西14个地级市中医类医疗机构有6个地区综合效率为1,仅占总体决策单元的42.8%,平均总体效率值为0.913。影响中医类医疗机构运营效率的因素有诊疗量、出院人数、中医药人员数、人均住院费用、地区常住人口、地区人均GDP、中医类医疗机构人员数以及政府医疗卫生机构拨款收入。[结论]广西中医类医疗机构运行效率总体效率较低,应当充分利用现有的医疗资源,扩大医疗产出,从而全面提高中医类医疗卫生机构的运行效率。

Objective To analyze and evaluate the operating efficiency of TCM medical institutions in Guangxi, in order to provide reference for promoting the inheritance, innovation and development of TCM and improving the level of TCM medical service capabilities during the “14th Five-Year Plan” period. Methods The data envelopment analysis(DEA)method was used to analyze the operational efficiency of Guangxi TCM medical institutions from two dimensions of longitudinal and transverse, with the efficiency value obtained by DEA as the dependent variable, and panel Tobit model was established to further analyze the factors affecting the operational efficiency of TCM medical institutions in Guangxi. Results The longitudinal analysis results showed that the overall efficiency of TCM medical institutions in Guangxi from 2016 to 2020 was low, with an average overall efficiency value of 0.976,two years of which were non-DEA effective status in 2018 and 2020. The transverse analysis results showed that in 2020,among the 14 prefecture-level TCM medical institutions in Guangxi, the comprehensive efficiency was 1 in 6 regions, which accounted for only 42% of all decision-making units and its average overall efficiency value was 0.913. The factors affecting the operation efficiency of TCM medical institutions include the number of diagnosis and treatment, the number of discharged patients, the number of TCM personnel, the per capita hospitalization expenses, the regional permanent population, the regional per capita GDP,the number of staffs in TCM medical institutions, and the income from government allocations for medical and health institutions. Conclusions The overall operation efficiency of TCM medical institutions in Guangxi is low. Existing medical resources should be fully utilized to expand medical output, so as to comprehensively improve the operation efficiency of TCM medical institutions.