医养结合视角下养老机构服务效率评价及影响因素研究——基于三阶段DEA与Tobit模型  

Evaluating the service efficiency of nursing homes and identifying influencing factors from the perspective of integrated medical and nursing care:a study based on the three-stage DEA and Tobit model

作　　者：庞慧敏[1] 李艳[1] 阮诗凝 吴镇杰 杨嘉玉 PANG Huimin;LI Yan;RUAN Shining;WU Zhenjie;YANG Jiayu(Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院,广东广州510095

出　　处：《现代医院》2025年第2期313-318,共6页Modern Hospitals

基　　金：广东省卫生经济学会立项课题(2024-WJMZ-63)。

摘　　要：目的从医养结合的视角评价我国养老机构服务效率并分析其影响因素。方法利用三阶段DEA模型剔除环境因素的影响分析我国各省(市、区)养老机构的效率,并用Tobit模型分析效率影响因素。结果研究期间传统DEA模型高估了我国31个省(市、区)养老机构综合效率和规模效率,低估了纯技术效率;环境因素人均生产总值、老年人口抚养比、城镇人口比重对投入变量有不同显著性水平的影响;调整后DEA效率值呈现稳态发展,综合效率为0.785、纯技术效率为0.870,规模效率为0.901;养老机构服务效率的影响因素为养老设施基础、地区人口规模、居民消费能力、照护对象失能程度、人力投入质量、医疗服务水平。结论三阶段DEA剔除环境因素影响后效率评价更准确;养老机构服务效率地区上呈现“东部最高,中部次之,西部最低”。Objective To evaluate the service efficiency of nursing homes in China from a medical care integration perspective and analyze influencing factors.Methods The three-stage Data Envelopment Analysis(DEA)model was applied to eliminate the influence of environmental factors to analyze the efficiency of nursing homes in various provinces in China.Additionally,a Tobit model was used to examine the determinants of efficiency.Results During the research period,the traditional DEA model overestimated the comprehensive efficiency and scale efficiency of nursing homes in 31 provinces,municipalities,and autonomous regions in China,and underestimated the pure technical efficiency.Environmental factors such as per capita GDP,the elderly dependency ratio,and the proportion of urban population impacted the input variables to significantly different extents,with a comprehensive efficiency score of 0.785,a pure technical efficiency score of 0.870,and a scale efficiency score of 0.901.Key influencing factors of the service efficiency of elderly care institutions included basic elderly care facilities,regional population size,residents’consumption capacity,degree of disability of the care recipients,quality of human resources,and capacity of medical services.Conclusion After eliminating the influence of environmental factors through the three-stage DEA,the efficiency evaluation is more accurate.The service efficiency of nursing homes varies across different regions in China:the eastern region exhibits the highest efficiency,followed by the central region and the western region.

关 键 词：医养结合 养老机构 服务效率 三阶段DEA TOBIT模型 

分 类 号：R197.7[医药卫生—卫生事业管理]