The Assessment On Efficiency Of General Hospital Using DEA & SFA Models

The health care system in China has been rapidly developed since the 2000s. During this process, the development matched people's basic health demand but the system had to face problems. The efficiency of general hospitals was one of them. Inspired with economic benefits, many general hospitals increased their number of beds, bought expensive equipments, tried to become luxury ones. And some of them engendered vicious competition. The research on the scale development of general hospitals is vital to efficiency of them,and so is the factors which influence the efficiency of general hospitals.Objective:(1) Construct the assessment index system of efficiency for general hospitals;(2) Assess the efficiency of general hospitals with DEA and SFA;(3) Analyze the causes of low efficiency with multi-regression analysis;(4) Analyze the relationships between scale and efficiency of general hospitals;Data and Methods: Data of 43 general hospitals of China was collected, covering only 2006.Data of Health Statistics of 2007 and general hospitals of 2006 were also used.Clustering analysis,non-parametric test and Spearman correlation were used to filtered the assessment index; DEA and SFA were used to calculate the score of efficiency of general hospitals.Results:(1) Filtering the index: Based on the preliminary data we could collect about the general hospitals, we use clustering analysis,non-parametric test and Spearman correlation to get the index. The indexes which covered 5 aspects were fixed assets,the number of employee per bed,the number of patients who leave hospital,ward turnover frequency,mortality,successful rescue rate for the acute and severe,operation revenue,the ratio of net assets to fixed assets,the average medical expense of outpatients and inpatients.(2) The results of DEA method: 65.12% hospitals'Overall Efficiency(OE) scores were 1, and remained Constant Return to Scale(CRS). 72.09% hospitals'pure Technical Efficiency (PTE) scores were 1, and No.7,8,9,12,17,30'OE were below 1,which mean the low efficiency of them came from scale.(3) The results of SFA method: the number of patients who leave hospital,ward turnover frequency,the number of employee per bed,operation revenue,the average medical expense of inpatients were significant at the level of 0.05, which mean these 5 variables contributed to the total cost a lot. The sequence of contribution was the average medical expense of inpatients,operation revenue,ward turnover frequency,the number of patients who leave hospital,the number of employee per bed.Discussion:(1) It should be put more emphasis on the filtering and application of assessment index system to avoid trustless results. Meanwhile, It should be apply statistical methods to filter index after used experience judgement,literature reviewing and experts consultation.(2) Different DEA models showed high correlation, the same was to different SFA models; DEA and SFA models indicated consistency.(3) The number of patients who leave hospital,ward turnover frequency,the number of employee per bed,mortality,operation revenue,the ratio of net assets to fixed assets,the average medical expense of outpatients and inpatients influenced efficiency differently.(4) High efficiency of hospitals would be gained at low or high bed capacity, and intermediate bed capacity match low efficiency.Suggestion:(1) Adjust key variables and scale of hospitals quickly to adapt the new Medical Reform; (2) Improve the efficiency of general hospitals under the circumstances of appropriate configuration of health resources;(3) The government should put more emphasis on the efficiency and scale of general hospitals;(4) The government should constitute appropriate hospital'beds standards to solve the problem of hospital scale;(5) The administrators of general hospitals should pay attention to the assessment of efficiency of general hospitals to improve the efficiency of hospitals;Conclusion:(1) The index system constructed with clustering analysis,non-parametric test and Spearman correlation, covering 5 aspects of hospital: hospital'scale and resources collocation,medical efficiency,medical quality,economic benefits,medical treatment expenses,was better than those constructed with experience,literature review and consultaltion.(2) The DEA and SFA results would be more accurate founded on before index system,and the DEA and SFA application on the assessment of efficiency of general hospitals,probing to the factors which influenced the efficiency and scale economy showed some consistency. DEA and SFA were complimentary when analyzing factors which influenced the efficiency.(3) The hospital managers should notice index such as ward turnover frequency which influnced efficiecy and cost of hospitals.(4) The relationships between hospital bed capacity and efficiency was"concvex-concave",which indicated that hospital bed capacity influced efficiecy.