Analysis Of Developing Situation And Medical Service Efficiency About The County Level Maternal And Child Health Care Institutions Of Ethnic Minority Depressed-area In Guangxi

Objective To understand the developing situation on the county level maternal and child health care institutions in ethnic minority depressed-area in2011-2014,Guangxi.To evaluate the medical service efficiency and further analyze the influence factors of those institutions,aiming to provide reference for the institutions to rectify themselves and the relevant departments to allocateresource scientifically and make regional health planning.Methods The research included 27 county level maternal and child health care institutions in ethnic minority depressed-area in Guangxi.The self-made questionnaire was about resource allocation,economic operation and medical service.The questionnaires were filled out by the institutions through the health and family Planning Commission in Guangxi.The developing situation was described by SPSS 16.0 statistics software.Medical service efficiency evaluation was analyzed with the data envelopment analysis by the DEAP2.1 software.The influence factors were analyzed with the Tobit model by Stata13.0 statistics software.Results 1.The developing situation on the county level maternal and child health care institutions in ethnic minority depressed-area in Guangxi:(1)Health resource allocation:In the year of 2014,the average of business premises area was 2948 m~2,The average of service housing area per bed was 57.14 m~2,meeting national standards.No institutions meet the national standards,which was the basic configuration of the major armamentarium.The designated bed capacity was less than the reality.The average owning rate of requirements was about 72.92%.Referring to the lower limit of the national standard,personnel staff rate was about 65%.89.18%medical personnel’s academic level were junior college or polytechnic school.73.52%medical personnel were primary professional title.61.65%medical personnel were under 61.65%.Medical care ratio was about 1:1.5.(2)economic operation:The income and expenditure increased year by year,while balance of payments increased.The main income was medical revenue,counted for 46%.The secondary was fiscal subsidies,counted for 32%.The drug income account decreased year by year.The main expenditure was medical revenue and wages and welfare revenue,counted for78%.The average asset-liability ratio was under 26%.The liquidity ratio was between 145%and 242%,while the quick ratio was between 135%and223%.Return on current assets was between 16%and 26%,fixed assets yield was between 12%and 21%.Fixed assets yield were higher than return on current assets.(3)medical service:Amount of service increased year by year..The average bed utilization rate was lower than the average of Guangxi.The average length of stay for discharge patients met the average of Guangxi.(4)Qualitative interview:Main ideas were that financial investment was insufficiency and public health services were great workload.2.The medical service efficiency evaluation and influencing factor on the county level maternal and child health care institutions in ethnic minority depressed-area in Guangxi:The averaged total efficiency,pure technical efficiency and scale efficiency were 0.900,0.937,0.955.There were 13DEA-effective institutions,accounted for 48.15%,14 pure technical effective DEA institutions,accounted for 51.85%,13 non-DEA effective institutions,accounted for 48.15%.The institutions increasing returns to scale were 7,while decreasing returns to scale were 6.Based on the Tobit regression analysis results,accounting of college graduated or above(P=0.038),the average daily physician visits(P=0.013),the bed utilization rate(P=0.005)are statistical significance,which were positive determinants.Conclusions The county level maternal and child health care institutions in ethnic minority depressed-area of Guangxi were lack of major armamentariuma,which the designated bed capacity was small.There were short of personnel staff,while human resource was unreasonable allocation.The health financial input was insufficiency.The medical service was under-utilization.The averaged total efficiency of those was different,which influence factors probably included the accounting of college graduated or above,physician visits per day,the bed utilization rate.Suggestion(1)Increase health financial input.(2)Increase personnel staff and develop human resources.(3)Take measures to increase medical service utilization.(4)Improve the economy efficiency.