大型综合公立医院效率特征及变动研究  

Efficiency characteristics and changes in tertiary general hospitals

作　　者：王小万[1] 刘丽杭[2] 匡绍华[3] 刘双梅[1] 毛燕娜[4] 游冒 

机构地区：[1]中国医学科学院卫生政策与管理研究中心,北京100020 [2]中南大学公共管理学院,湖南长沙410083 [3]中国聋儿康复研究中心,北京100029 [4]南方医科大学,广东广州510515 [5]国家卫生计生委卫生发展研究中心,北京100191

出　　处：《中国卫生政策研究》2015年第10期33-40,共8页Chinese Journal of Health Policy

基　　金：国家自然科学基金(71173237)

摘　　要：目的:从静态与动态两个层次分析大型综合公立医院的效率特征及变动趋势。方法:采用数据包络分析的C^2R-DEA和BC^2-DEA模型与Malmquist指数模型,利用50家大型公立医院2006—2012年的人员、设备、资产、医疗服务等投入—产出指标,构建适宜分析模型。结果:约10%~12%样本医院处在相对有效运行状态,其配置效率均值与规模效率均值分别为0.956与0.943,接近效率前沿,其效率表现相对较好;而纯技术效率均值、技术效率均值、成本效率均值与整体效率均值分别为0.796,0.784,0.714和0.714,与效率前沿差距较大,其效率表现相对较差。同时,样本医院处于规模报酬递减状态的医院由7.69%增加到26.31%,而处于规模报酬递增状态的医院由80.77%下降到58.34%;其技术进步与Malmquist生产率指数、技术效率指数、纯技术效率指数与规模效率指数的变化保持比较稳定的一致性,并呈现持续改善与稳步发展的趋势。结论:大型公立医院正面临着发展动力与激励机制的转换,不仅需要转变医院管理理念与发展模式,也需要构建有关结构、过程和结果的最佳效率评价标准,以促进包括政府职能在内的医院治理与发展模式的转变。Objective： To analyze the efficiency characteristics and trend of tertiary general public hospitals from both static and dynamic perspectives. Methods： After collecting data of personnel, equipment, assets, health services and other inputs-output indicators from 50 tertiary public hospitals from 2006 to 2012 , this paper uses C2 R-DEA and BC2-DEA models, as well as Malmquist Index model to build suitable analysis model. Results：About 10%～12% of the sample hospitals are in a relatively effective operational state, and the mean values of allocation effi-ciency and scale efficiency are 0. 956 and 0. 943, respectively, which are close to the efficient frontier. The mean values of pure technical efficiency, technical efficiency, cost efficiency and overall efficiency are 0. 796, 0. 784, 0. 714 and 0. 714, respectively, which are relatively poor compared with the efficiency frontier. Moreover, the number of hospitals that are in the state of diminishing returns to scale increased from 7 . 69% to 26 . 31%, while the number of hospitals that are in the state of increasing returns to scale decreased from 80. 77% to 58. 34%. The changes in techno-logical progress, Malmquist productivity index, technical efficiency index, pure technical efficiency index and scale effi-ciency index remained a relatively stable consistency, and showed continuous improvement and steady development trend. Conclusion：Tertiary general public hospitals are facing the transformation of driving force for development and incentive mechanisms. This needs not only to change the management concept and development mode of the hospitals, but also to build evaluation standards of optimum efficiency that are relevant to the structure, process and outcome, in order to pro-mote the transformation of hospital governance and development model that includes the functions of government.

关 键 词：三级综合医院 DEA MALMQUIST指数 效率 评价 

分 类 号：R197[医药卫生—卫生事业管理]