基于数据包络分析和随机前沿分析的天津市基层医疗卫生机构中医诊疗服务运营效率研究  

The Operational Efficiency of Traditional Chinese Medicine Diagnosis and Treatment Services in Primary Medical Institutions in Tianjin Based on DEA and SFA

作　　者：李杰 杜汋[1,3] 邵屾[4,5] 潘东 张雅欣 LI Jie;DU Yue;SHAO Shen;PAN Dong;ZHANG Yaxin(School of Public Health,Tianjin Medical University,Tianjin 300070,China;Medical Service,School and Hospital of Stomatology,Tianjin Medical University,Tianjin 300070,China;Tianjin Basic Public Health Service Quality Control Center,Tianjin 300070,China;College of Management and Economy,Tianjin University,Tianjin 300072,China;Institute of Disaster and Emergency Medicine,Tianjin University,Tianjin 300072,China;Medical Service,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300120,China;Medical Service,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津医科大学公共卫生学院,天津市300070 [2]天津医科大学口腔医院医务科,天津市300070 [3]天津市基本公共卫生服务质量控制中心,300070 [4]天津大学管理与经济学部,天津市300072 [5]天津大学应急医学研究院,天津市300072 [6]天津市中医药研究院附属医院医务科,300120 [7]天津医科大学总医院医务科,天津市300052

出　　处：《中国全科医学》2025年第16期1980-1986,1991,共8页Chinese General Practice

基　　金：天津市哲学社会科学规划项目(TJKSZDWT1836)。

摘　　要：背景中医药的传承、创新及发展得到了国家的高度重视,然而目前我国基层中医诊疗发展尚不均衡,不同机构的中医诊疗服务运营效率差距较大。目的通过分析2021年天津市基层医疗卫生机构的中医诊疗服务运营情况,为基层医疗卫生机构的中医药发展提供参考依据。方法于2021年,采用全面调查方法收集天津市16个行政区域(Dis)(Dis1~6为市内六区,Dis7~10为环城四区,Dis11为滨海新区,Dis12~16为远郊五区)共计270家基层医疗卫生机构的相关数据,并综合运用数据包络分析(DEA)中的变动规模报酬(BCC)模型、固定规模报酬(CCR)模型和随机前沿分析(SFA)两种方法,从不同角度分析基层医疗卫生机构的中医诊疗服务运营效率。通过文献研究将DEA模型的投入指标设为中医类执业医师数、中医科床位、中医诊疗设备台数;产出指标设为中医医疗收入、中医诊疗人次数、以中医为主的出院人次数、上门中医药服务人次数。SFA模型除产出指标增添总收入一项外,余与DEA所设指标一致。结果各区中有7个区的基层医疗卫生机构的中医诊疗服务运营情况有效,Dis9 DEA弱有效,8个区DEA为无效。有8个区规模报酬呈递增状态,7个区规模报酬不变,Dis3呈递减状态。8个非DEA有效的区,各区3项投入指标均存在冗余情况,产出指标中各区中医医疗收入项不足现象较为严重。SFA结果中Dis1~6技术效率(0.733~0.838),均为高效区;Dis7~10技术效率(0.691~0.912),3个高效区、1个中效区;Dis11技术效率(0.885)为高效区;Dis12~16(0.399~0.849)3个高效区、2个中效区。DEA结果与SFA结果基本一致,中医类执业医师数对运营效率有正影响。结论天津市各区基层医疗卫生机构中医诊疗服务运营效率总体偏低,但整体发展趋势向好,且有区域特点,整体来看Dis1~6优于Dis7~10,Dis7~10优于Dis11~16,各区应根据实际合理规划,避免资源投入过剩以及产出不足情�Background The inheritance,innovation,and development of traditional Chinese medicine have received high attention from the country.However,the development of grassroots traditional Chinese medicine diagnosis and treatment in China is still uneven,and the operational efficiency of traditional Chinese medicine diagnosis and treatment services in different institutions varies greatly.Objective By analyzing the operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in Tianjin in 2021,this study provides a reference for the development of traditional Chinese medicine in grassroots medical institutions.Methods In 2021,a comprehensive survey method was used to collect relevant data from a total of 270 primary healthcare institutions in 16 administrative regions of Tianjin(Dis1-6 being the six districts within the city,Dis7-10 being the four districts around the city,Dis11 being the Binhai New Area,and Dis12-16 being the five districts in the suburbs),and two methods,BCC and CCR models in Data Envelopment Analysis(DEA)and Stochastic Frontier Analysis(SFA),were comprehensively applied to analyze the operational efficiency of traditional Chinese medicine diagnosis and treatment services in institutions from different perspectives.Through literature research,the input indicators of the DEA model were set as the number of traditional Chinese medicine practitioners,the number of traditional Chinese medicine beds,and the number of traditional Chinese medicine diagnosis and treatment equipment;The output indicators were set as traditional Chinese medicine medical income,number of traditional Chinese medicine diagnosis and treatment personnel,number of discharged patients mainly using traditional Chinese medicine,and number of on-site traditional Chinese medicine service personnel.The SFA model was consistent with the indicators set by DEA,except for the addition of total income as an output indicator.Results The operation of traditional Chinese medicine diagnosis and treat

关 键 词：社区卫生服务 数据包络分析 数据分析 统计 运营效率 基层中医诊疗 

分 类 号：R197.1[医药卫生—卫生事业管理]