四川省紧密型县域医共体建设对医院效率的影响分析  

Impacts of the Integrated County Medical Community Pilot on hospital efficiency,Sichuan

作　　者：卢鑫 张晓星 潘杰[1] LU Xin;ZHANG Xiao-xing;PAN Jie(West China School of Public Health,Sichuan University,Chengdu,Sichuan 610044,China)

机构地区：[1]四川大学华西公共卫生学院,四川成都610044

出　　处：《现代预防医学》2024年第10期1839-1844,1851,共7页Modern Preventive Medicine

摘　　要：目的评估各投入要素对医院产出的边际效应,并识别紧密型县域医共体建设对医院效率的影响。方法采用时变随机前沿模型估计各医院前沿生产面与医院效率,并通过双重差分模型识别医共体政策对于医院效率的净效应,分析该效应在不同类型医院间的异质性。结果相较于对固定资产、万元以上设备的投入,医院产出对床位、执业医师与注册护士投入弹性更大;2016年至2022年四川省内医院效率有所增加,且在医共体政策试点后增幅更为明显;观察期内,医共体政策对医院效率约有1.17个百分点的净提升效应(P<0.001),且营利性医院对于该效应更为敏感(P<0.05)。结论医共体政策提高了试点区县医院效率,对营利性医院提升更大。Objective To evaluate the marginal effects of inputs on hospital outputs and the impacts of Integrated County Medical Community on hospital efficiency.Methods A stochastic frontier model was employed to estimate the production frontier and efficiency of each hospital,and a difference-in-difference method was utilized to identify the net effect of Integrated County Medical Community on hospital efficiency,including a heterogeneity analysis of this effect.Results Our findings revealed that,in contrast to investments in fixed assets and equipment,hospital output exhibited a heightened elasticity in response to investments in beds,practicing physicians,and registered nurses.From 2016 to 2022,hospitals in Sichuan Province demonstrated an augmented level of efficiency,with a more conspicuous improvement observed subsequent to the initiation of Integrated County Medical Community.The net positive effect of this policy on hospital efficiency in was approximately 1.17 percentage points(P<0.001),where for-profit hospitals exhibited a greater sensitivity to this effect(P<0.05).Conclusion The Integrated County Medical Community pilot in Sichuan Province significantly improved the overall efficiency of hospitals,with a notably greater improvement observed in for-profit hospitals.

关 键 词：紧密型县域医共体 医院效率 随机前沿模型 双重差分法 

分 类 号：R19-0[医药卫生—卫生事业管理]