Study On Operational Efficiency Of County-level Public General Hospitals In Henan Province

Objective:To evaluate and analyze the operating efficiency of county-level public general hospitals in Henan province from 2014 to 2018,and discuss the influencing factors of the operating efficiency.To provide references and suggestions for improving the efficiency and development quality of county-level hospitals and the next comprehensive medical reform.Methods:Descriptive statistical analysis methods were used to analyze the economic operation and input-output index changes of county-level public general hospitals.The SE-SBM model was used to calculate the static efficiency of county-level public general hospitals.The Global Malmquist index based on SE-SBM model was used to measure the dynamic efficiency of county-level public general hospitals.Tobit regression model based on the panel data was used to analyze the factors affecting the efficiency of county-level public general hospitals.Results:1.From 2014 to 2018,the total amount of health resources,the total amount of income and expenditure and the output of medical and health services of county-level public general hospitals in Henan Province showed a trend of increasing year by year,but the operating capacity of hospitals decreased year by year.2.From 2014 to 2018,the operating efficiency of county-level public general hospitals in Henan province was relatively ineffective.And the pure technology efficiency hindered the improvement of the hospital efficiency.There were no significant differences in the efficiency of hospitals in different income areas.Overall,the comprehensive technical efficiency and pure technical efficiency of hospitals in high-income areas were higher than in other regions,while the scale efficiency of hospitals in middle-income areas was higher than in other areas.There were no statistically differences in the efficiency of different size hospitals.The comprehensive technical efficiency and pure technical efficiency of the large-scale hospitals were relatively higher than that in other hospitals,but the scale efficiency was the lowest.The critical value of beds in county-level public general hospitals is 500,and the overall scale shows an increasing trend.3.Under the joint action of internal and external factors,the factors affecting the comprehensive technical efficiency and pure technical efficiency of county-level public general hospitals included the number of health technicians,the ratio of doctors to nurses,the utilization rate of hospital beds,the asset liability ratio,the asset liability turnover ratio and financial input,among which the number of health technicians and asset liability ratio had a negative impact.Factors influencing scale efficiency included bed utilization rate,asset turnover rate,per capita disposable income of residents and permanent resident population.Only asset turnover rate had a negative impact on scale efficiency.4.From 2014 to 2018,the Tfpch of county-level public general hospitals in Henan Province showed an average annual growth rate of 4%,among which,the growth rate of the Tech was 8.1% per year,while the Effch showed an average annual decline trend of 2.3%.The Effch restricted the growth of hospital productivity.Conclusion:The low management level and resource utilization rate of county-level public general hospitals in Henan province limit the improvement of efficiency.Hospitals should improve the level of refinement and scientific standardization of management,and pay attention to the reasonable planning of development scale.The factors that affect the operating efficiency of the hospital mainly appear inside the hospital.While strengthening the internal management,the proportion of financial subsidies can be appropriately increased to help improve the operating efficiency.