基于DEA-Malmquist模型的浙江省中医类医院运行效率评价

Evaluation on operational efficiency of traditional Chinese medicine hospitals in Zhejiang Province based on DEA-Malmquist index model

[目的]分析浙江省中医类医院运行效率现状并对二级、三级中医类医院进行对比分析,探索其影响因素,为浙江省中医类医院优质高效发展提供参考。[方法]采用描述性统计分析方法描述各项指标基本情况,采用DEA-BCC模型和DEA-Malmquist指数模型分别从静态、动态分析医院效率和变化趋势。[结果]2021年3项投入指标[执业(助理)医师数、实有床位数、万元以上设备台数]与2017年相比分别上升了23.2%、10.4%和49.6%;2021年3项产出指标(总诊疗人次数、出院人数、医疗收入)与2017年相比分别上升了22.3%、7.3%和12.2%。2019年DEA有效的医院最多、共15家(19.5%),2021年最少、共10家(13%),5年间DEA均有效的医院有4家(5.2%),绝大多数医院处于非DEA有效;2017-2021年,TFP指数均值为0.982,EC指数均值为1,TC指数均值为0.982。[结论]卫生投入逐年增加,但浙江省中医类医院整体运行效率下降;二级公立中医院运行效率比三级公立中医院高;浙江省中医类医院存在无序规模扩张;技术进步是促进医院效率提升的推动力。

Objective This paper analyzes the operational efficiency of traditional Chinese medicine hospitals in Zhejiang Province and exploves the influencing factors by contrasting secondary and tertiary TCM hospitals,so as to provide references for the high-quality development of TCM hospitals in Zhejiang Province.Methods Descriptive statistical analysis method was used to describe the basic situation of each index,and DEA-BCC model and DEA-Malmquist index model were used to analyze the static and dynamic hospital efficiency and changing trend.Results In 2021,the three investment indicators,the number of licensed(assistant)physicians,the number of beds,and the number of equipment above 10000 yuan increased by 23.2%,10.4%,and 49.6%compared to 2017,respectively.The three output indicators,total number of patients,the number of discharges,and medical income,increased by 22.3%,7.3%and 12.2%,respectively.In 2019,there were the most DEA valid hospitals,with a total of 15 hospitals(19.5%).In 2021,there were the least DEA valid hospitals,with a total of ten hospitals(13%).Over the past five years,there were four DEA valid hospitals(5.2%),and the vast majority of hospitals were non-DEA valid.From 2017 to 2021,the average TFP index was 0.982;the average EC index was 1,and the average TC index was 0.982.Conclusions The investment in health care has been increasing year by year,but the overall operational efficiency of TCM hospitals in Zhejiang Province has decreased.The operational efficiency of secondary public TCM hospitals is higher than that of tertiary public TCM hospitals.There is a disorderly expansion of TCM hospitals in Zhejiang Province.Technological progress is the driving force for improving hospital efficiency.