县级综合医院规模影响因素结构方程模型定量研究  

Quantitative Study on the Determinants for Bed Scale of County General Hospital Based on Structure Equation Model

作　　者：董四平[1,2] 肖婧婧[1] 方鹏骞[2] 

机构地区：[1]卫生部医院管理研究所,北京100191 [2]华中科技大学同济医学院医院管理与发展研究中心,武汉430030

出　　处：《中国卫生经济》2011年第1期74-77,共4页Chinese Health Economics

基　　金：国家自然科学基金项目(70673026)

摘　　要：目的:探寻综合医院床位规模的影响和决定因素;方法:应用结构方程模型(SEM)定量测量刻画医院床位规模的主要影响因素、影响程度及其相互关系。结果:区域内经济人口状况、医院内部经营绩效是床位规模的重要影响因素;医疗市场竞争程度是中度影响因素;卫生资源存量水平存在较轻程度的负向影响;医院每百门诊人次住院比率、病床使用率、医院人均业务收入三者之间存在密切关系。结论:(1)县级医院床位规模的决定因素包括区域内经济人口状况、医院经营收支水平、医疗市场竞争程度等方面;(2)部分医院床位规模发展与当地卫生资源存量水平不相适应,缺乏成本控制动机与目标;(3)医院通过自身经营实现规模发展,"每百门诊人次住院比率"是医院诱导需求的敏感反应指标。Objective： To explore the determinants for bed scale of general hospitals. Methods： Structural Equation Model was employed to measure the main factors, influence degree and their relationships. Results： The demographic and economy situation and hospital performance are the most important factors, and the competitive environment of medical marketing is the moderate factors; the stock level of health resources has lesser degree of impact on the bed scale; there are close relationships among the ratio of inpatient per 100 outpatients, occupancy rate of beds and hospital income per capita. Conclusions： （1） The most important factors for bed size of county general hospitals are the demographic and economy situation, hospital performance, the competitive environment and so on; （2） the development of bed scale of some hospitals does not meet the stock level of local health resources and they are lack of motivation and objectives of cost control; （3） hospitals finished their expansion of bed scale based on their own business development, and the ratio of inpatient per 100 outpatients can be used as a sensitive indicator to judge the existence and its degree of induced demand in health service.

关 键 词：综合医院 床位规模 影响因素 结构方程模型 

分 类 号：R197.3[医药卫生—卫生事业管理]