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目的基于DEA-BCC模型与DEA-Malmquist指数模型,评价湖南省17家改革试点县级公立医院2012、2013年的运行效率,为卫生决策者提供数据与理论支持。方法选取湖南省17家县级公立医院2012年与2013年的年报数据并筛选出投入产出指标,采用DEA-BCC模型分析2012与2013年的效率与报酬状态,采用Malmquist指数模型分析2012-2013年全要素生产率变化情况。结果 17家公立医院年均综合效率由0.805提高至0.909,纯技术效率由0.842提高至0.915,规模效率由0.956提高至0.993,DEA有效的医院由6家(35.3%)增长至8家(47.1%);17家医院全要素生产率变动均值为1.037,技术变动指数平均值为0.903,效率变动平均值为1.148,纯效率变动指数均值为1.100,规模效率变动指数均值为1.043,10所医院全要素生产率提高,占比58.8%;7所医院全要素生产率降低,占比41.2%。结论17家医院综合效率整体较前一年有提升,但仍有部分医院存在资源利用不充分或过剩的问题;整体呈全要素生产率提高,但技术衰退明显。医院应将重点放在技术提升与人才培养上,并适度控制发展规模。
OBJECTIVE To evaluate the operating efficiency of 17 pilot Pilot County public hospitals in Hunan Province in 2012 and 2013 based on DEA-BCC model and DEA-Malmquist index model, and to provide data and theoretical support for health policy-makers. Methods The annual report data of 17 county-level public hospitals in Hunan Province in 2012 and 2013 were selected and input-output indicators were screened. The efficiency and remuneration status of 2012 and 2013 were analyzed by DEA-BCC model. Malmquist index model was used to analyze the data of 2012-2013 Annual total factor productivity changes. Results The average annual comprehensive efficiency of 17 public hospitals increased from 0.805 to 0.909, the pure technical efficiency increased from 0.842 to 0.915, the scale efficiency increased from 0.956 to 0.993, and the effective DEA hospitals increased from 6 (35.3%) to 8 (47.1% ). The mean of total factor productivity of 17 hospitals was 1.037, the average of technical change index was 0.903, the average of efficiency change was 1.148, the average of pure efficiency index was 1.100, and the average of scale efficiency index was 1.043. The total factor productivity Increase, accounting for 58.8%; 7 hospitals, total factor productivity decreased, accounting for 41.2%. Conclusion The overall efficiency of 17 hospitals increased from the previous year, but some hospitals still had inadequate or excessive use of resources. The overall TFP increased but the technology declined significantly. The hospital should focus on technological upgrading and personnel training, and moderate control of the scale of development.