摘要
目的测量公立三级综合医院成本效率及其构成要素,分析其成本效率的影响因素。方法采用数据包络分析法的COST、CCR、BCC模型,分别测量我国3个省份141所样本医院的成本效率、配置效率、技术效率、纯技术效率和规模效率值。对数据进行描述性分析和多元线性回归分析。结果2018年样本医院成本效率值为0.632,配置效率值为0.929,技术效率值为0.675,纯技术效率值为0.732,规模效率值为0.917。10所(7.09%)样本医院处于规模报酬不变状态,41所(29.08%)样本医院处于规模报酬递减状态,90所(63.83%)样本医院处于规模报酬递增状态。地区人均GDP以及医院的床位使用率、平均住院日、每门急诊人次平均收费水平等,对样本医院成本效率值的影响具有显著性。结论技术效率是影响成本效率的主要原因,纯技术效率是提升技术效率的关键因素,不断提升医院内部管理水平是提高技术效率的主要和必要途径。内部因素对成本效率影响较大。降低平均住院日、提高床位使用率、降低每门急诊人次平均收费水平等,有利于提高医院成本效率。
Objective To measure the cost efficiency and its components of 141 public tertiary hospitals of China and measure the influencing factors.Methods COST, CCR and BCC model of DEA were used to measure the cost efficiency, allocative efficiency, technical efficiency, pure technical efficiency and scale efficiency.Results In 2018, the values of cost efficiency, allocative efficiency, technical efficiency, pure technical efficiency, scale efficiency of the sample hospitals were 0.632, 0.929, 0.675, 0.732 and 0.917 respectively. 10(7.09%)sample hospitals were in the state of constant returns to scale, 41(29.08%)sample hospitals were in a state of decreasing returns to scale, while 90(63.83%)sample hospitals were in a state of increasing returns to scale. The regional GDP per capita and the bed utilization rate, average hospitalization days, average charge per output of hospital had significant impacts on the cost efficiency.Conclusions Technical efficiency is the main factor affecting cost efficiency, and pure technical efficiency is the key factor for technical efficiency. Continuously improving the internal management level of the hospital is the main and necessary approach to enhance the technical efficiency of public tertiary hospitals. Internal factors have greater impacts on the efficiency of the sample hospitals. Reducing the average length of stay, increasing the utilization rate of beds and reducing the average charge level per outpatient can improve the cost efficiency of the hospitals.
作者
李萌
郭淑岩
杨威
杨婷婷
黎浩
董四平
Li Meng;Guo Shuyan;Yang Wei;Yang Tingting;Li Hao;Dong Siping(National Institute of Hospital Administration,National Health Commission,Beijing 100044,China;Global Health Institute,Wuhan University,Wuhan 430072,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2020年第11期891-895,共5页
Chinese Journal of Hospital Administration
基金
国家自然科学基金(71573061)。
关键词
医院
公立
成本效率
COST模型
数据包络分析
Hospital,public
Cost efficiency
COST model
Data envelopment analysis(DEA)
