| ObjectiveBased on the relevant literature of hospital bed efficiency evaluation model home andabroad, the research lays the theoretical foundation for this study via knowing aboutmedical resources utilizaiton efficiency. It collects data related to hospital medicalresources efficiency evaluation index through the field survey, then it optimizes the bedsefficiency evaluation model in previous studies. Moreover, it constructs the entitycomplexity index to adjust the hospital evaluation indexes. The research screens input andoutput indicators of DEA evaluation from the perspective of social resources, and it teststhe stability of the model. Finally, optimization results are evaluated which can provideadvice for hospital medical resourses management and reduce waste of health resources.MethodsThis research uses literature research method consult domestic and foreign literaturesand policy material about medical institutions medical resources utilizaiton efficiencyevaluation. It selects Beijing, Shandong, Henan, Anhui as survey area, and collectsinformation via second-hand data collection method, including genera situation, the firstpage of hospital patients medical records and other information and data related withmedical resources utilization Referencing case mix index in the United States, this researchmodifies the calculation formula for the diseases of complexity index which domesticscholars have put forward; Combined with the expert opinions, it constructs a bedefficiency evaluation index system from the perspective of social resources; it provides acomprehensive assessment among40hospitals in2011with DEA and DEA crossevaluation comparing differences between two kinds of evaluation methods of comprehensive evaluation results.Results1. The research status review and defect analysis of the medical resources utilizationefficiency evaluation model in general hospitalsThe research group selected efficiency evaluation indicators with factor analysis, clusteranalysis and other statistical methods according to17hospitals in Beijing in previous study,and it evaluated medical resources utilization efficiency via Data Envelopment Analysis(DEA). Due to the limitations of previous research, medical resources efficiency evaluationmodels which were set up earlier have some defects. Firstly, the data used by the evaluationmodel is derived from the hospitals in Beijing. Because the economy is more prosperousthan other else and its health care keeps leading level, so the efficiency evaluation model isnot applicable in hospitals which come from any area in China. Secondly, the calculationmethod of the case mix index is relatively simple. Furthermore, the classification is notdetailed enough, and the only two nodes contain limited information so that the case mixcannot reflect the complete case diagnosis information.2. Calculation of the entity complexity index in medical resources utilizationefficiency evaluation modelResearch collected hospital patients’ medical records of42general hospitals in Beijing,Shandong, Henan and Anhui provinces in2011, including a total of1,739,445data records.Based on the calculation formula of entity complexity index in the previous studies, itappropriately modified factors in the formula. For this research, it uses Median length ofstay, the rate of unhealed patients, median of total charge and constituent ratio of diseasesto compute the ECI (entity complexity index)3. Optimization and stability test of the medical resources utilization efficiencyevaluation model indexes based on disease management in urban general hospitalsVia literature analysis of input and output indicators used to evaluate the medicalresource utilization, from the perspective of sociology resources, the research selects suitable indicators which are applied to medical resources utilizaiton efficiency evaluationmodel. On the premise that the sensitivity and availability are guaranteed, it determines thefinal input and output indicators in the way that the experts brainstormed, discussed andevaluate the importance of indicators. Moreover, the input indicators are the total hospitalcost, the number of doctors, the number of nurses, beds actually opened, the value of fixedassets; the output indicators are the number of discharges and the total bed days. Finally,The internal consistency reliability detection method and the factor analysis are used tocalculate the alpha value and the construct validity in order to prove that the optimizedmodel has better reliability and validity comparing with the two models.4．The optimization effect assessment of the medical resources utilization efficiencyevaluation model indexes based on disease management in urban general hospitalsIt evaluates the beds utilization efficiency with the CCR model in DEA. The results show that theDEA relative efficiency evaluation value of13hospitals are equal to1, and the slack variables s+=0, s-=0.it suggests that the13hospitals are effective in DEA and the effective hospital codes are rankedby super-efficiency model. While the relative efficiency values of the other hospitals are less than1,namely, these hospitals are DEA inefficient. After the efficiency of the inefficient hospitals is improved,the discharges and inpatient days will get different degrees of growth. Furthermore, CCR and BCCmodels are used to analyze the technical efficiency and scale efficiency. According to the results,20hospitals are effective in technology and scale. Finally, it provides a comprehensive assessmentamong40hospitals in2011with DEA and DEA cross evaluation comparing differencesbetween two kinds of evaluation methods of comprehensive evaluation results.Discussion and SuggestionsThe beds utilization efficiency calculated in BCC model suggests that the number oftechnology effective hospitals have been about1.4times than the number of technologyand scale effective hospitals. However, although the hospitals in the current size have fullyused all medical resources, there are still6hospitals are technology inefficient and theirscale returns are increasing. It suggests that the hospitals should be appropriately expanded.In addition, there are14effective hospitals for scale. The scale of these hospitals has reached ideal state with constant scale at the current technical level. The hospitals shouldimprove the management and increase the utilization efficiency of existing resourcesHospital beds configuration should be fully aware of the social total input and outputrequirements. It suggests that efficiency evaluation model should be applied to hospital bedutilization scientific evaluation; Hospitals should attach great importance to hospital bedsefficiency and prevent from blind expansion. Medical resources utilizaiton efficiencyshould be raised as high as possible, furthermore, the medical resources utilizaitonefficiency shoud be taken as evaluation indexes of hospital performance management;Hospitals should formulate improvement measures and management strategies aimed at keyindicators which affect beds utilization efficiency, considered with the actual situation ofhospital. In addition, on the premise that the outputs of hospital are guaranteed, hospitalsshould reduce investment properly and improve the utilization efficiency of hospital beds.Innovation and shortage of researchFirstly, the innovation of this study is the application of entity complexity index. Thedisease complex degree index (ECI) is adopted to correct related indicators of medicalresources utilization efficiency in the perspective of disease. It eliminates the differences ofhospitals which have different diseases and it makes medical resource utilization efficiencyof different hospital comparable. Secondly, DEA is improved and DEA cross evaluation isapplied to evaluate hospital medical resource utilization efficiency. It prevents that inputand output coefficient of different decision-making units is not reasonable. Moreover, itevaluates hospitals in the same standard. Due to time constraints, the sample size is slightlyinsufficient, thus the secondary and tertiary hospitals are not separated. |
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