四川省公立医院成本效率及其影响因素的实证研究  

An Empirical Study on the Cost Efficiency and its Influencing Factors of Public Hospitals in Sichuan Province

作　　者：唐娴[1] 廖菁[2] 潘晓平[3] 钟若冰[2] 张靖[2] 全婷[2] 张菊英[1] 韩亮[2] 曹勤[4] 

机构地区：[1]四川大学公共卫生学院,610041 [2]四川省医学科学院四川省人民医院,610072 [3]中国疾病预防控制中心妇幼保健中心,100050 [4]四川省医学情报研究所,610072

出　　处：《中国卫生统计》2011年第6期654-657,共4页Chinese Journal of Health Statistics

基　　金：四川省卫生厅科研基金资助项目(项目编号:100546;080341)

摘　　要：目的测算四川省公立医院的成本效率,并探讨其影响因素,为提高公立医院的成本效率提供参考。方法自制调查问卷调查四川省公立医院2003～2007年投入、产出等情况,利用随机前沿超越对数成本函数测算成本效率并探讨成本效率影响因素。结果样本平均低效率为21.37%。职工总人数、医护比、药品收入占总收入的比例、二级以下医院、中医院与成本效率呈负相关,人员支出与业务支出比、市级和县级医院、时间趋势与成本效率呈正相关。结论四川省县级及以上公立医院成本效率处于一般水平,还有待进一步提高。控制医院规模(如减少职工总人数)、提高护士比例、减少以药养医的程度、提高职工福利等有利于提高成本效率。省级医院、二级以下医院、中医院成本效率较低,应引起关注。Objective To measure the cost efficiency（CE） and explore its influencing factors of public hospitals in Sichuan province.Methods Based on the panel data of 284 public hospitals from 2003 to 2007,the Stochastic Frontier with Translog Cost Function was estimated.Results The efficiency was negatively associated with the number of staffs,doctor/nurse ratio,higher medicine income,being lower than class-two hospitals and traditional Chinese medical hospital.Was positively related with personnel expenditure/medical expenditure ratio,municipal and county hospitals and time trend.Conclusion It is necessary to improve the cost efficiency of public hospitals in Sichuan province.Controlling the hospital scale,raising nurse proportion,reducing the degree of medicine supporting and increasing the staff welfare may be advantageous to improve the efficiency.And the provincial hospitals,being lower than class-two hospitals and traditional Chinese medical hospitals should be gained more attention because of low cost efficiency.

关 键 词：公立医院 成本效率 影响因素 随机前沿方法 超越对数成本函数 

分 类 号：R197.3[医药卫生—卫生事业管理]