| According to the datas of the health resource inputs,outputs,and the disposition of the 24 community health service centers(from the four suburbs in Shenyang)in 2006 year,this paper choosed the comprehensive evaluation and the relative efficiency indexes that possessed the important,representative,attainable characteristics,established two different index systems.The efficiency of the centers were evaluated by the methods of TOPSIS,Principal Component Analysis and DEA (Data Envelopment Analysis)respectively,furthermore,the selection of evaluating indexes,construction of evaluating indexes systerm,the correlations of the results obtained with the different methods were analyzed;Adopted the one factor and mutiple factor analysis method to find out the currrent state of job satiscation of community health services staff,studied the key affected factors and putted forward relevant strategy and measures.And discussed the main problems of the the community health service in four suburbs of Shenyang in order to provide more policy supports for the Region Health Programming and the development of the suburb community health service in Shenyang and other cities.Data and MethodsThe objects of this study were 24 community health service centers of four suburbs in Shenyang.The datas were obtained mainly from the annual statistics review of finance,facility and human resource and also from the questionnaire of community health service centers and community health services staffs. The main methods for this study were literature method and statistical methods.Iterature method:A lot of research papers available in English and Chinese were referred to understand the progress in this field.The efficiency evaluating indexes of community health service centers were selected by the utilization of these literatures.Statistics methods:the methods of TOPSIS,Principal Component Analysis and DEA(Data Envelopment Analysis)were used to evaluate the efficiency of community health service centers.Meanwhile,T test,one fator analysis of variance and mutiple liner regression were adopted to analysis the currrent state of job satiscation of community health services staffs.ResultsEvaluation of the community health service centerThe paper constructed the comprehensive evaluation and the realtive efficiency evaluation of community health service centers system according to the principal of the sensitive,important,representative,attainable characteristics.The methods of TOPSIS,Principal Component Analysis and DEA(Data Envelopment Analysis) were used to evaluate the efficiency of the targeted community health service centers.1.the result of the comprehensive evaluation of community health service centersThirteen evaluation indexes:the percapita government health subsidy,the percapita sevice room area,the percapita fixed assets,the percapita total income,the percapita total expenditure,the percapita quality of health sevice one year,the community health service training radio,the middle and high prefessional title radio,the composition radio of academic education,the health service development rate,same trending of the outpatient and emergency expense,scores of the satisfaction of the patients,scores of the satisfaction of the staffs. The rank of TOPSIS evaluation:The rank of Principal Component Evaluation:The correlation analysis of the TOPSIS and Principal Component evaluation result** correlation is significant at the 0.011evel(2-tialed) The result of the multivariate stepwise regression analysis:the C score of the TOPSIS as the dependent variables,the thirteen evaluation indexes as the independent variables.R Squared=0.948(Adjusted R Squared=0.934)2.the result of the relative evaluation of community health service centersThe evaluation indexes of the DEA:the number of health technicians,the total expenditure,the number of community health service training,the outpatient and emergency expense(five input indexes);the total income,the quality of health sevice one year(two output indexes).The results of the DEA: The thirteen evaluation indexes of the TOPSIS and PCA:The rank of TOPSIS evaluation:same trending of the percapita government health subsidy,same trending of the percapita sevice room area,same trending of the percapita fixed assets,the percapita total income,same trending of the percapita total expenditure,the percapita quality of health sevice one year,the community health service training radio,the middle and high prefessional title radio,the composition radio of academic education,the health service development rate,same trending of the outpatient and emergency expense,scores of the satisfaction of the patients,scores of the satisfaction of the staff.The results of the TOPSIS:The results of the PCA: The correlation analysis of the TOPSIS,Principal Component and DEA evaluation result* correlation is significant at the 0.051evel(2-tialed)The result of the multivariate stepwise regression analysis:the score of the DEA as the dependent variables,the percentage of the input surplus and the output deficit on the basis of the target values and ideal values of the ineffective unites as the independent variables.The satisfaction evaluation of community health services staffsThe mutiple linear regression result of the satisfation factors of the staffs: R Squared=1(Adjusted R Squared=1)The Optimal scaling result of the the satisfation factors of the staffs: 1,The multi-indexes system of the comprehensive evaluation and the relative efficiency evaluation is made up,whcih includes the scale,quality,benefit and efficiency of the community health service centers according to the national policy,finacial input system and the present situation of the community health service centers,and is different from the old ones.2,Compared with TOPSIS and Principal Component Analysis methods,DEA method is more suitable for the diagnosis evaluation of the relative efficiency in the community health service centers,and can point out the reasons of the low efficiency of inefficient units.For managers,the DEA method has more feasible and realistic guiding significance than other two methods.3,Inadequate health input,waste of resources and operating inefficiencies are the most important problems of the community health service centers of the four suburbs of Shenyang City,suggestions for strengthening scientific management, improving the utility of resources and reducing unnecessary waste are put forward for the government and health service institutions.4,The job satisfaction of the current community health sevices staffs of the four suburbs of Shenyang City is low,working environment and job income are the key affecting infactors of the job satisfaction of staffs,the government and the operators should increase the job income,distribute the rational task,and putforward relevant strategy and measures to improve the equity. |
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