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目的:评价基本药物实施前后,乡镇卫生院生产率变化情况。方法:通过分层随机抽样和现场调查收集30家样本乡镇卫生院的投入和产出数据,利用Deap 2.1测算乡镇卫生院2007—2012年的Malmquist全要素生产率指数变化情况。结果:30家乡镇卫生院从2006—2012年职工总数呈逐年递增趋势,但在2009年职工总数比2008年有所下降;年占用总床日数呈逐年增加趋势,从2008年开始年增长率呈逐年降低趋势,2010年到达阶段性最低点;每职工平均负担年占用床日数呈逐年上升趋势,但年增长率呈逐年下降趋势,在2010年降低到阶段性最低点;年检验总次数逐年增加,2008年增长率达到阶段性最大值;2009年以后年增长率变化趋于平缓。2008年以后30家乡镇卫生院的年生产率指数平均值均小于1,提示乡镇卫生院的生产力呈逐年衰退趋势;标准差呈逐年减小,提示乡镇卫生院的生产力有逐年趋同趋势。经秩和检验,发现每两年之间差异无统计学意义。结论:基本药物制度实施前后,乡镇卫生院生产率呈逐年降低趋势,但总体变化不显著。
Objective: To evaluate the changes of the productivity of township hospitals before and after the implementation of essential medicines. Methods: Input and output data of 30 sample township hospitals were collected by stratified random sampling and field survey, and the changes of Malmquist total factor productivity index of township hospitals from 2007 to 2012 were estimated by Deap 2.1. Results: The total number of staff and workers in 30 township health centers increased year by year from 2006 to 2012, but the total number of staff and workers in 2009 dropped from that in 2008. The total number of beds occupied in each year increased year by year. From 2008 onwards, the annual growth rate was The number of bed occupancy beds per worker averaged year by year increased year by year, but the annual growth rate showed a downward trend year by year, which dropped to the lowest point in 2010; the annual total number of tests increased year by year In 2008, the growth rate reached the maximum in stages; the annual growth rate after 2009 tends to be gentle. The average annual productivity index of 30 township hospitals was less than 1 after 2008, suggesting that the productivity of township hospitals was declining year by year; the standard deviation showed decreasing year by year, suggesting that the productivity of township hospitals was increasing year by year. The rank sum test found no significant difference between every two years. Conclusion: Before and after the implementation of the basic drug system, the productivity of township hospitals was decreasing year by year, but the overall changes were not significant.