基于Bootstrap-DEA-Tobit模型的湖北省县级公立医院相对效率及全要素生产率研究  

Relative efficiency and total factor productivity of county-level public hospitals in Hubei Province based on Bootstrap-DEA-Tobit model

作　　者：王梓萱 宋康 杨天旭 程佳蕙 贾常离 王全[1,2] 黎浩[1,2] Wang Zixuan;Song Kang;Yang Tianxu;Cheng Jiahui;Jia Changli;Wang Quan;Li Hao(School of Public Health,Wuhan University,Wuhan University,Wuhan 430072,China;Global Health Institute,Wuhan University,Wuhan 430072,China)

机构地区：[1]武汉大学公共卫生学院,武汉430072 [2]武汉大学全球健康研究中心,武汉430072

出　　处：《广西医科大学学报》2023年第8期1414-1420,共7页Journal of Guangxi Medical University

基　　金：湖北省妇幼保健机构发展战略研究(No.250000221)。

摘　　要：目的:分析2019—2021年湖北省县级公立医院相对效率及全要素生产率变化情况及其影响因素,为县级公立医院医疗服务能力提升提供参考。方法:描述2019—2021年湖北省59家样本医院投入产出指标发展情况,采用经重复抽样纠偏的Bootstrap-DEA方法对不同年份、不同县域医院的静态效率值进行测算,使用Bootstrap-Malmquist-DEA指数模型分析其动态效率变化,并利用Tobit回归模型分析综合技术效率值的影响因素。结果:2019—2021年样本医院综合技术效率值分别为0.824 3、0.626 6、0.713 9;59家医院3年间全要素生产率下降6.4%,其中技术效率和技术进步分别下降1.9%、4.4%。综合技术效率与病床周转次数、医疗收入呈正相关关系,与人均住院费用呈负相关关系。结论:湖北省县级医院相对效率及全要素生产率呈现先降后升的发展态势,县域医院间发展不平衡,需进一步优化资源配置和要素投入,加强管理,提升技术效率和技术进步,以实现湖北省县级公立医院的高效可持续发展。Objective:To analyze the relative efficiency and total factor productivity changes and influencing factors of county-level public hospitals in Hubei province from 2019 to 2021,so as to provide reference for the improvement of county-level public hospital,service capabilities.Methods:The development of input and output indicators of 59 sample hospitals in Hubei Province from 2019 to 2021 was described.The static efficiency values of hospitals in different years and counties were measured by Bootstrap-DEA method with repeated sampling correction,and the dynamic efficiency changes were analyzed by Bootstrap-Malmquist-DEA index model.The Tobit regression model was used to analyze the influencing factors of the comprehensive technical efficiency value.Results:From 2019 to 2021,the comprehensive technical efficiency values of the sample hospitals were 0.8243,0.6266 and 0.7139,respectively.During the three years,the total factor productivity of 59 hospitals decreased by 6.4%,among which the technical efficiency and technical progress decreased by 1.9%and 4.4%,respectively.The comprehensive technical efficiency was positively correlated with the number of bed turnover and medical income,and negatively correlated with the average hospitalization expenses.Conclusion:The relative efficiency and total factor productivity of county-level hospitals in Hubei Province decrease first and then increase,and the development of county-level hospitals is unbalanced.Therefore,it is necessary to further optimize the resources allocation and factor input,strengthen the management and improve the technical efficiency and technological progress to realize the efficient and sustainable development of county-level public hospitals in Hubei Province.

关 键 词：县级公立医院 技术效率 全要素生产率 TOBIT模型 

分 类 号：R197.3[医药卫生—卫生事业管理]