摘要
目的 通过测算和比较新医改十年来广州市公立医院和民营医院的运行效率,以期为卫生行政部门和医院管理部门优化医院管理提供决策依据。方法 运用数据包络分析方法(DEA模型)对2009—2019年广州市公立医院和民营医院的运行效率进行测算和比较,通过构建Tobit模型分别对公立医院和民营医院的效率值进行影响因素分析。结果 DEA效率比较发现:新医改十年来,公立医院的综合技术效率和规模效率要普遍优于民营医院,纯技术效率与民营医院相差不大;DEA效率影响因素发现:医师年均负担诊疗人次和医院总支出这两个因素对公立医院和民营医院效率均有显著正向影响,其他因素在不同模型中的显著性存在较大差异。结论 公立医院和民营医院都应根据实际情况合理调整自身规模与结构;积极推动鼓励民营医院发展的政策予以落实,进一步完善民营医院发展环境;公立医院应严格管控医院的药占比,并提高医师劳务技术价值;社会应重视护理人员的培养,扭转医护比例倒置问题。
Objective To measure and compare the operational efficiency between public hospitals and private hospitals in Guangzhou in the past ten years of the new healthcare reform so as to provide decision-making references for health administrative departments and hospital management departments to optimize hospital management.Methods Data Envelopment Analysis(DEA) was used to measure and compare the operation efficiency of public hospitals and private hospitals in Guangzhou from 2009 to 2019. Tobit model was built to analyze the influencing factors of the efficiency of public hospitals and private hospitals respectively.Results By comparative analysis of DEA efficiency, it was found that in the past ten years of the new healthcare reform, the comprehensive technical efficiency and scale efficiency of public hospitals were generally better than those of the private hospitals, and the pure technical efficiency was not significantly different from that of the private hospitals. By analyzing the influencing factors of DEA efficiency, it was found that the average annual burden of doctors on diagnosis and treatment and the total expenditure of hospitals had a significant positive impact on the efficiency of the public hospitals and private hospitals, and other factors had significant differences in different models.Conclusion Both public hospitals and private hospitals should adjust their scale and structure reasonably to their actual situations. Private hospitals should promote the implementation of policies encouraging its development and further improve its development environment;public hospitals should strictly control the proportion of drugs in hospitals and improve the technical value of doctors’ labor services;and the society should pay attention to the training of nursing staff and solve the problem of inverted proportion of doctors and nurses.
作者
范阳东
陈美雪
吴伟伦
李雅婷
李文翠
许潇栋
胡丙杰
FAN Yangdong;CHEN Meixue;WU Weilun;LI Yating;LI Wencui;XU Xiaodong;HU Bingjie(School of Health Management,Guangzhou Medical University,Guangzhou 511436,China;School of Basic Medical Sciences,Guangzhou Medical University,Guangzhou 511436,China)
出处
《现代医院》
2023年第2期239-243,共5页
Modern Hospitals
基金
国家社科基金重大项目(17ZDA080)
广东省医学科学技术研究基金项目(A2015498)
广东省哲学社会科学规划基金项目(GD22CYJ27)
广州市卫生健康科技重大项目(2020A031006)。
关键词
数据包络分析
公立医院
民营医院
效率
影响因素
Data envelopment analysis
Public hospitals
Private hospitals
Efficiency
Influencing factors
