Evaluating Efficiency Of Township Hospital In Guangxi Based On Data Envelopment Analysis

Objective： governments gradually increased special construction investmentfor township hospitals in recent years, speed up the implementation of the ruralhealth service system construction and development planning, and activelypromote the building of rural medical and health care infrastructure and capacity,vigorously improve the rural medical and health conditions, improve the qualityof medical and health services. With the increase of input, the output efficiencyof township hospitals has gradually become a concern.Now through analysising the input and output of township hospitals，toknow if township hospitals achieve the rational allocation of resources andmaximize the output. And to explore factors that influence the input-outputefficiency of township hospitals,to provide reference for the optimal allocationof rural health resources. This study provides policy advice for townshiphospitals of resources utilization, to promote the further development of primaryhealth care institution. Methods： This research mainly used Excel2003, MaxDEA5.2, deap2.1,stata12.0software, Descriptive analysis the input and output basic situation ofGuangxi township hospitals; Using CCR model and BCC model in dataenvelopment analysis (DEA) analysis the efficiency of township hospitals in thewhole cities of Guangxi, By using the Malmquist index model for thelongitudinal dynamic analysis of township hospital efficiency;Using Tobitregression model to explore factors that influence efficiency of townshiphospitals.Results：1the results of the descriptive analysis (1) institution: by2012, theaverage each villages and towns in guangxi have a health clinics in towns andtownships.(2) health workers: number of doctors in2008-2012, growth isrelatively slow, number of doctors per thousand agricultural population belowthe national average level for five consecutive years.(3) health facilities:business occupancy area from2008to2012, relatively slow growth ofagricultural population of beds per thousand for five consecutive years lowerthan the national average level.(4) health spending: in2010, financial aid thehighest year-on-year growth rate. Since2010, the average of fiscal subsidies andfiscal subsidy proportion of their revenues were higher than the national averagelevel.2(1) static analysis results: In2012, the number of DEA effective townshiphospital is216, the number of non DEA effective township hospital is800,DEA efficiency is21.3%. The number of pure technical effective townshiphospital is287, the number of non pure technical effective township hospitalis729, Pure technical efficiency is28.2%.The number of scale effectivetownship hospital is278, the number of non scale technical effective township hospital is738, scale efficiency is27.4%.(2) dynamic analysis results: from2008to2009, Guangxi township hospitals total factor productivity is0.984;From2009to2010, Guangxi township hospitals total factor productivity is1.068; From2010to2011, Guangxi township hospitals total factor productivityis1.081; From2011to2012, Guangxi township hospitals total factorproductivity is1.396.(3) the analysis results of influence factors: there are17factors in the tobit regression model. The factors that affect the efficiency of thehospital and have statistical significance, are the number of bed, totalexpenditure,the total income, the number of outpatient visits,the bed utilization ratio, financial assistance, Fiscal subsidies incomeproportion of revenues. Among them, the total income, the number ofoutpatient visits, bed utilization rate, Fiscal subsidies income proportion ofrevenues are positively correlated with hospital efficiency, the number of bed,total expenditure, financial aid are negatively correlated with efficiency of thehospital.Conclusions：(1) continue to increase the input on the hardware and software.The emphasis is to increase the number of the physician and make areasonable allocation plan for beds and institutes.(2) pay attention to technology to improve the efficiency of township hospitals.By changing the management concept of administrators, raises the technicallevel of technical personnel to strengthen the construction of the connotation ofthe township hospitals.(3) improve relevant policies to ensure the smoothy running of townshiphospitals.