Analysis Of The Economic Operating Efficiency And Impact Factors Of Shanghai Suburban Secondary Hospitals From2003to2011

ObjectiveGrasping the impact of the New Rural Cooperative Medical System(NRCMS) and theNew Medical Reform Policy(NMRP), we examine the economic efficiency of13Ruralsecondary hospitals. Using the time of implementation of the relevant health policy as a timenode, we examine changes in hospital efficiency Before and after the implementation of thepolicy and analyze the main factors impacting the hospital operating efficiency，which issignificant to control the hospital’s running costs and improve their productivity, decrease themedical costs, and optimize the allocation of health resources at Shanghai suburban area.ContentIn this research, we selected13secondary hospitals at Shanghai suburbs to analyze andevaluate their economic situation and efficiency changes from the year2003to2011bydescriptive analysis, DEA and Malmquist index analysis. And then, we explore the factorsinfluencing the hospital’s operational efficiency by Individual fixed effects model.ResultsThe results of operating conditions: hospitals in general are at a disadvantage in medical;these hospitals have irrational income and expenditure structure and low-quality income;hospitals lack sufficient government investment and have difficulties in operation.The results of production efficiency: the Central Hospital’s production efficiencygradually improved, especially in the year of2008-2011; the General Hospital’s productivityvary widely throughout the study period; the improvement of Production efficiency benefitmore from technological progress.The results of affecting Factors:1.Dummy variables D2and D3: ECS and MPI efficiencyvalues were increased in three periods, and the latter higher than the previous, which isexplain that the health policy promoted production efficiency of the hospital to some extent.2.Employees: MPI in three periods of regression coefficients are negative, but increasing,which is explain that Employees’ enthusiasm is growing, but their quantity neededadjustments.3. Actual open beds: it has a positive impact on the MPI in early periods,suggesting the size of hospital beds is moderate; late regression coefficient becomes negative,indicating an increase over bed size in this stage.4. Outpatient and emergency visits and theproportion of discharges: ECS regression coefficient decreases, indicating outpatientefficiency is a major factor affecting the efficiency of the hospital in early stage; efficiency ofhospital inpatient operating efficiency even more significant impact, but hospital efficiency ismore obvious in Late stage.5. Fixed assets: fixed assets of hospitals are overall high, medical instruments and equipment are underutilized.6. Drug addition and the proportion ofoutpatient and inpatient drugs: It significantly affected Tch in the third stage, suggesting thatat this stage the hospital strictly controlled drug addition, the proportion of outpatient andinpatient drugs decreased.According to the results, it is recommended to improve utilization of hospital resources,to attract patients for treatment by improving the quality and technical level medical services,provide differentiated services and other measures, which is promoting hospitals to achieveeconomies of scale. Strengthen internal hospital management, improve and perfect thehospitals’ elements combination efficiency through improving the personnel system, s triageand referral system and so on. Continue to mobilize and improve the medical staff enthusiasmfor work. According to the actual, set beds and purchase of large medical equipmentreasonably, improve their population coverage and utilization. Increasing governmentspending, continue to control drug addition and revise the medical service prices, reducing theproportion of drug costs, and compensating the medical losses by other reasonable means.