Study On Equity And Operation Efficiency Of Hospital Health Resources Allocation In Beijing

Hospital bear the major responsible for providing medical service, holds an absolute advantage in the allocation of health resources, Beijing as the core of our country city,there are a lot of hospitals and health resources in here.Analyze the hospital health resources allocation fairness and efficiency is very necessary for the future development.Objective:Basing on describe the allocation and utilization of all kinds of health resources in the hospital of Beijing during the 12th five-year period, using Theil index method to evaluate the equality of health resource allocation, and use the method of DEA to evaluate the comprehensive efficiency of hospital operation.Finally use the front calculation results to analyze the relationship between fairness and efficiency. This study can provide the reference for Beijing health development in 13th five year period.Methods:In this paper, thro ugh literature research this study summarize the commonly used methods and evaluation index of hospital health resources allocation fairness and efficiency,then use expert consultation method to determine methods and indicators in this paper.Theil index method is used to evaluate Beijing hospitals health resources allocation fairness, found the differences that exist in the allocation of health resources.Using the method of DEA to evaluate the comprehensive efficiency and scale of hospital operation,estimating the appropriate output of hospitals.Results:1.The current situation of hospital health resources allocation and utilization efficiency:In 2014, there are 608 hospitals in Beijing, increased by 11.36% than in 2010;The total number of health technical personnel was 154200,53300 medical practitioners,71400 registered nurses, five years has increased by about 20%-30%;The hospital has 102900 beds, up by 18.98%;The number of high value equipment was 191500, the total value of 36.748 billion yuan and the growth rate of more than 50%;Hospital financial aid achieve at 13.27 billion yuan, with an increase of 79%.There are more resources distributed in The capital function core area and city expanded function area, Dongcheng and Xicheng District per capita resources advantage is obvious.During "12th five-year"period,Beijing municipal hospital outpatient and inpatient services has increased by about 50%;daily average outpatient was 10.14 and the daily average inpatient was 1.4 hospital beds, less than the average level in 2010.Hospital beds turnoverd an average of 28.63 times in 2014,working day 317.35 days,sickbed utilization rate is 86.95%, each inpatient in the hospital for 10.73 days, the hospital beds utilization rate and working days decreased in half of the districts.Outpatient treatment cost 415.9 yuan, inpatient medical costs 18900 yuan per capita.The capital function core area and city expanded function area undertaked more than 70% of the medical service work in Beijing, the resource utilization efficiency is relatively high.2.Theil index evaluation of health resources:In 2014, the Theil index of hospitals’ number is 0.0982;health technical personnel Theil index is 0.1512, medical practitioners is 0.1532, registered nurses is 0.1492;hospital beds’Theil index is 0.1219;the Theil index of high value equiments’number and worth are 0.2615 and 0.2485;Financial aid is 0.3344.Besides the hospital quantitative index is slightly higher than 2010, other resources’index were reduced.Regional Theil index contribution rate reached more than 80%.3.Evaluation the efficiency of health resources by DEA:Choosing the unmber of health technical personnel,sickbed and medical expenditure as input indicators and outpatient,sickbed turnover and medical income as output index.Using the output as the guidance of CCR and BCC model to evaluate the efficiency of hospital.In 2014, there were only 16 hospitals which were comprehensive technology effective and scale effective,pure technical effective had 45 hospitals.The overall comprehensive technical efficiency scored an average of 0.3655,0.4956 pure technical efficiency and scale efficiency at 0.7867.54.52%of hospitals in a state of decreasing scale,41.84% of the hospitals for increasing scale.For non DEA effective hospitals, output need to increase by more than 1 times.4.The relationship between fairness and efficiency:Us ing principal components analysis to merge a new indicators which canon behalf of the human resources, material resources and financial resources. Then calculate the Theil index of this new indicators.Compared the result of Theil index with DEA ebaluation, the relationship between fairness and efficiency not seen obvious quantitative relation.Conclusions:"12th five-year" period, the Beijing municipal hospital health resources has increased, equipment and financial capital increased the fastest.There are more health resources distributed in the capital function core area and city expanded function area, suburban county is lower.Outpatient service work efficiency, sickbed utilization rate and burden of patients still need to improve. Health resources allocation fairness order, regional differences are the main causes of unfair.The hospital comprehensive operation efficiency is low, the medical service ability still has great room to improve."13th five-year" period, the Beijing municipal hospital need to design a more reasonable health resources plann, the key to solve the suburban counties’ health resources development, narrow the regional difference. Improving the efficiency of the hospital comprehensive,increase the service output.