北京大学学报(医学版) ›› 2018, Vol. 50 ›› Issue (3): 408-415. doi: 10.3969/j.issn.1671-167X.2018.03.004

• 论著 • 上一篇    下一篇

北京市三级公立医院效率及其影响因素

景日泽1,2,章湖洋1,2,徐婷婷1,2,张鲁豫1,2,方海2△   

  1. (1. 北京大学公共卫生学院卫生政策与管理系, 北京100191; 2. 北京大学中国卫生发展研究中心, 北京100191)
  • 出版日期:2018-06-18 发布日期:2018-06-18
  • 通讯作者: 方海 E-mail: hfang@hsc.pku.edu.cn
  • 基金资助:
    国家自然科学基金(71774006、71373013)资助

Study on the efficiency of tertiary public hospitals and its influencing factors in Beijing

JING Ri-ze1, 2, ZHANG Hu-yang1, 2, XU Ting-ting1, 2, ZHANG Lu-yu1, 2, FANG Hai2△   

  1. (1.Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China; 2. China Center for Health Development Studies, Peking University, Beijing 100191, China)
  • Online:2018-06-18 Published:2018-06-18
  • Contact: FANG Hai E-mail: hfang@hsc.pku.edu.cn
  • Supported by:
    Supported by National Natural Science Foundation of China (71774006, 71373013)

摘要:  目的:评价北京市2006—2015年间三级公立医院的综合技术效率,探讨其影响因素,并提出相应的政策建议。方法:使用数据包络分析测算北京市三级公立医院的综合技术效率、单纯技术效率和规模效率,利用Malmquist指数模型分析其动态效率情况,最后运用随机效应面板Tobit模型分析综合技术效率影响因素。结果:北京市三级公立医院的平均综合技术效率和单纯技术效率水平较高,分别由2006年的0.44和0.51升至2015年的0.62和0.68,两种效率值在0.5~0.8之间所占比例最高;规模效率值绝大部分分布于0.8~1.0之间,大部分医院处于规模报酬递减状态;医院全要素生产率平均每年以5.78%的速度进步,得益于技术效率和生产技术分别以年3.77%和1.94%的速度在进步,进一步分解技术效率进步,单纯技术效率在以年3.21%的平均速度进步,规模效率仅有0.53%的年平均进步速度。综合技术效率与床位周转率、医师年均担负诊疗人次、医护比呈正相关,与床位数、门诊住院人次比、卫生技术人员占比和药占比呈负相关。结论:严格控制三级公立医院规模,注重医院生产技术的创新和应用,转变医院内部管理水平和管理模式,推进精细化管理,以实现可持续发展。

关键词: 三级公立医院, 效率, 数据包络分析, 影响因素

Abstract: Objective: To evaluate the comprehensive technical efficiency of the tertiary public hospitals in Beijing between 2006 and 2015 and explore its influencing factors, so as to propose corresponding policy suggestions. Methods: The data envelopment analysis was employed to evaluate the comprehensive technical efficiency, pure technical efficiency and scale efficiency of the tertiary public hospitals in Beijing. Malmquist index model was used to analyze the changes of the above three dynamic efficiencies. Finally, random-effect panel tobit model was utilized to analyze the influencing factors of the comprehensive technical efficiency. Results: The average comprehensive technical efficiency and pure technical efficiency of the tertiary public hospitals in Beijing were relatively high, and they had respectively increased from 0.44 and 0.51 in 2006 to 0.62 and 0.68 in 2015, and the highest proportion of two kinds of efficiency values was between 0.5 and 0.8. Most of the scale efficiency values distributed between 0.8 and 1.0, and the majority of hospitals were in a state of decreasing returns to scale. The total factor productivity of hospitals had been increasing at an average rate of 5.78% per year due to the double progress of technical efficiency and technology at annual rates of 3.77% and 1.94% respectively, further decomposing technological efficiency change, and the pure technical efficiency change increased at the speed of 3.21% per year, and the annual average rate of progress in scale efficiency was only 0.53%. The comprehensive technical efficiency was positively correlated with the turnover rate of beds, annual visits per doctor, the ratio of doctors to nurses, and negatively correlated with the number of beds, the ratio of outpatients to inpatients, the proportion of medical technical personnel, and the proportion of drugs. Conclusion: Future health policies should strictly control the scale of tertiary public hospitals, pay attention to the innovation and application of hospital technology, change the hospital internal management le-vel and management model, promote refined management, and achieve sustainable development.

Key words: Tertiary public hospitals, Efficiency, Data envelopment analysis, Influencing factors

中图分类号: 

  • R153.2
[1] 张艺潇,冯文. 决策树在贫困农村老人就诊影响因素中的应用[J]. 北京大学学报(医学版), 2018, 50(3): 450-456.
[2] 孙美平,简伟研. 不同管理系统下的医院运营效率比较[J]. 北京大学学报(医学版), 2017, 49(3): 483-488.
[3] 赵雨薇,吴明. 北京市不同居住时间的农村流动人口门诊服务利用状况及其影响因素[J]. 北京大学学报(医学版), 2017, 49(3): 476-482.
[4] 李杨,李子剑,张克,田华,刘延青,蔡宏,李锋,赵旻暐. 膝髋关节置换术非计划性暂停手术的原因分析[J]. 北京大学学报(医学版), 2017, 49(2): 231-235.
[5] 吴士艳,张旭熙,杨帅帅,孙凯歌,贾卫兰,邵春欣,吴芹,宣小伟,刘永昌,刘思佳,孙昕霙. 北京市某近郊区居民身体活动情况及其影响因素[J]. 北京大学学报(医学版), 2016, 48(3): 483-490.
[6] 张桂林, 潘习龙. 基于数据包络分析方法的北京市农村基本公共卫生服务项目效率评价[J]. 北京大学学报(医学版), 2013, 45(2): 264-.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张三. 中文标题测试[J]. 北京大学学报(医学版), 2010, 42(1): 1 -10 .
[2] 赵磊, 王天龙 . 右心室舒张末期容量监测用于肝移植术中容量管理的临床研究[J]. 北京大学学报(医学版), 2009, 41(2): 188 -191 .
[3] 万有, , 韩济生, John E. Pintar. 孤啡肽基因敲除小鼠电针镇痛作用增强[J]. 北京大学学报(医学版), 2009, 41(3): 376 -379 .
[4] 张燕, 韩志慧, 钟延丰, 王盛兰, 李玲玲, 郑丹枫. 骨骼肌活组织检查病理诊断技术的改进及应用[J]. 北京大学学报(医学版), 2009, 41(4): 459 -462 .
[5] 林红, 王玉凤, 吴野平. 学校生活技能教育对小学三年级学生行为问题影响的对照研究[J]. 北京大学学报(医学版), 2007, 39(3): 319 -322 .
[6] 丰雷, 程嘉, 王玉凤. 注意缺陷多动障碍儿童的运动协调功能[J]. 北京大学学报(医学版), 2007, 39(3): 333 -336 .
[7] 李岳玲, 钱秋瑾, 王玉凤. 儿童注意缺陷多动障碍成人期预后及其预测因素[J]. 北京大学学报(医学版), 2007, 39(3): 337 -340 .
[8] . 书讯[J]. 北京大学学报(医学版), 2007, 39(3): 225 -328 .
[9] 牟向东, 王广发, 刁小莉, 阙呈立. 肺黏膜相关淋巴组织型边缘区B细胞淋巴瘤一例[J]. 北京大学学报(医学版), 2007, 39(4): 346 -350 .
[10] 张宏文, 丁洁, 王芳, 杨惠霞. 一例X连锁Alport综合征女性妊娠期随访[J]. 北京大学学报(医学版), 2007, 39(4): 351 -354 .