效率视角下湖南省三级公立医院韧性评价及影响因素研究  

Resilience evaluation and influencing factors of tertiary public hospitals in Hunan province from the perspective of efficiency

作　　者：王栋[1] 田勇泉[2] 李君 李佳玲 Wang Dong;Tian Yongquan;Li Jun;Li Jialing(Comprehensive Evaluation Center,Xiangya Hospital,Central South University,Changsha 410078,China;Institute of Hospital Management,Central South University,Changsha 410078,China;Center for Medical Services Administration,Hunan Provincial Health Commission,Changsha 410008,China;School of Business Administration,Hunan University of Technology and Business,Changsha 410205,China)

机构地区：[1]中南大学湘雅医院综合评价中心,长沙410078 [2]中南大学医院管理研究所,长沙410078 [3]湖南省卫生健康委医疗管理服务指导中心,长沙410008 [4]湖南工商大学工商管理学院,长沙410205

出　　处：《中华医院管理杂志》2024年第1期17-24,共8页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(72104076);湖南省教育厅科学研究项目(22B0630)。

摘　　要：目的分析湖南省三级公立综合医院在重大突发事件背景下的医院韧性水平和影响因素,为韧性医院建设以及提升医疗卫生应急能力提供参考。方法选取湖南省参加国家三级公立医院绩效考核的50家综合医院作为研究样本,数据来源于公立医院绩效考核管理平台,利用2019—2021年面板数据进行分析。采用超效率DEA-Malmquist模型分析样本医院的静态和动态效率,并基于效率指标构建医院韧性指数模型,运用熵权TOPSIS法进行综合评价,采用单因素方差分析和logistic逐步回归法分析医院韧性的影响因素。结果2019—2021年湖南省三级公立综合医院技术效率值均数分别为0.861、0.749和0.810,2020年相比2019年全要素生产率下降12.3%,2021年相比2020年全要素生产率提升8.3%,2021年相比2019年全要素生产率下降5.7%。重大突发事件背景下,湖南省三级公立综合医院的医院韧性指数为0.557,超大规模医院和国家卫生健康委员会委属(管)医院的医院韧性指数相对较高,分别为0.647和0.715。Logistic逐步回归分析结果显示,高级职称医务人员数、微创手术占比、平均住院日是影响医院韧性的关键因素,OR值分别为1.005、1.261和0.406。结论湖南省三级公立综合医院的资源配置效率有待提升,重大突发事件背景下医院韧性的整体水平欠佳;建议从应急人才储备、关键核心技术攻关与应用以及优化运营效率管理理念和机制等方面推进韧性医院建设。Objective To analyze the resilience level and influencing factors of tertiary public general hospitals in Hunan province under the background of major emergencies,so as to provide reference for the construction of resilient hospital and improvement of emergency response ability.Methods Fifty tertiary public general hospitals in Hunan province that participated in the performance evaluation of national tertiary public hospitals were selected as research samples.The data was sourced from the performance evaluation management platform of public hospitals from 2019 to 2021.The DEA-Malmquist model was used to analyze the static and dynamic efficiency,hospital resilience index model was constructed based on the efficiency indicators,the entropy weight TOPSIS method was used for comprehensive evaluation,and the influencing factors of hospital resilience were analyzed by one-way ANOVA and logistic stepwise regression method.Results From 2019 to 2021,the average technical efficiency values of tertiary public general hospitals in Hunan province were 0.861,0.749 and 0.810.The total factor productivity in 2020 decreased by 12.3%compared with that in 2019,the total factor productivity in 2021 increased by 8.3%compared with 2020,and the total factor productivity in 2021 decreased by 5.7%compared with that in 2019.In the context of major emergencies,the hospital resilience index of tertiary public general hospitals in Hunan province was 0.557,and the hospital resilience index of super-scale hospitals and hospitals under the National Health Commission was relatively high,with indexes of 0.647 and 0.715,respectively.The logistic stepwise regression model included three indicators:the number of medical staff with senior professional titles,the proportion of minimally invasive surgery and the average length of stay,and the OR values were 1.005,1.261 and 0.406,respectively.Conclusions The efficiency of tertiary public general hospitals in Hunan province needs to be improved,and the resilience level of hospitals under the background

关 键 词：医院 公立 医院韧性 超效率数据包络分析 MALMQUIST指数 影响因素 

分 类 号：R197.32[医药卫生—卫生事业管理]