我国公立医院服务效率及其影响因素研究  

Study on service efficiency and its influencing factors of public hospitals in our country

作　　者：黄琼[1] 吴安娜[1] 杨颖 高飞 HUANG Qiong;WU Anna;YANG Ying;GAO Fei(Personnel Section,Nanjing Emergency Medical Services,Nanjing 210003,China)

机构地区：[1]南京市急救中心人事科,江苏南京210003

出　　处：《现代医学》2024年第11期1758-1764,共7页Modern Medical Journal

基　　金：2021年度南京市卫生科技发展专项资金项目管理类课题(A类)(GAX21286);2021年度南京市卫生科技发展专项资金项目科研管理类课题(B类)(GBX21312)。

摘　　要：目的:本研究旨在探究公立医院服务效率及其影响因素,以提供科学依据和政策建议,促进医疗卫生事业的可持续发展。方法:本研究选取了中国31个省级行政区的公立医院为研究对象,数据主要来源于《中国统计年鉴》《中国卫生健康统计年鉴》等,时间跨度为2013年至2021年。采用三阶段数据包络分析(DEA)模型对公立医院服务效率进行分析,投入指标包括执业(助理)医师数量、实有床位数、公立医院数量,产出指标包括平均住院日、门急诊人次数、医师日均担负住院床日数,环境变量包括地区人均GDP、地区政府卫生支出占卫生总费用、地区城镇人口占比、地区老龄人口占比。采用Tobit模型进行公立医院服务效率影响因素分析。结果:研究发现,区域异质下公立医院的服务效率并不相同,东部地区、中部地区、西部地区和东北地区的公立医院服务效率分别是0.953、0.911、0.944和0.879;医护比与每千人口执业(助理)医师数量对公立医院服务效率具有显著正向关系,正相关系数分别为0.002和0.016,而病床使用率与公立医院服务效率呈显著负向关系,负相关系数为-0.001。结论:通过分析公立医院服务效率及其影响因素,本研究为解决公立医院面临的医疗资源紧张、服务质量不均衡等问题提供了科学依据。未来的研究可以进一步探讨医院管理模式、医疗技术创新等因素对服务效率的影响,以推动医疗卫生事业的持续发展。Objective:To explore the service efficiency of public hospitals and its influencing factors,providing scientific evidence and policy suggestions to promote the sustainable development of the healthcare sector.Methods:The study selected public hospitals in 31 provincial-level administrative regions of China as the research objects,with data mainly sourced from the China Statistical Yearbook and China Health Statistics Yearbook,covering the period from 2013 to 2021.A three-stage DEA model was used to analyze the service efficiency of public hospitals.Input indicators included the number of practicing(assistant)physicians,the number of available hospital beds,and the number of public hospitals.Output indicators included the average length of hospital stay,the number of outpatient and emergency visits,and the number of hospital bed-days per physician per day.Environmental variables included regional per capita GDP,the proportion of regional government health expenditure in total health spending,the proportion of regional urban population,and the proportion of the regional elderly population.A Tobit model was applied to analyze the influencing factors of public hospital service efficiency.Results:The study found that service efficiency of public hospitals varied across regions.The efficiency scores for public hospitals in the Eastern,Central,Western,and Northeastern regions were 0.953,0.911,0.944,and 0.879,respectively.The physician-to-nurse ratio and the number of practicing(assistant)physicians per 1,000 people had a significant positive relationship with the service efficiency of public hospitals,with positive correlation coefficients of 0.002 and 0.016,respectively.In contrast,bed utilization rate showed a significant negative relationship with service efficiency,with a negative correlation coefficient of-0.001.Conclusion:By analyzing the service efficiency of public hospitals and its influencing factors,this study provides scientific evidence for addressing issues such as strained medical resources and imbalanced

关 键 词：公立医院 服务效率 影响因素 

分 类 号：R-1[医药卫生]