Analysis On Operational Efficiency And Its Influencing Factors Of Rural Health Centres In Hami Prefecture

ObjectiveTo investigate operating efficiency of rural health service centres in Hami Prefecture from 2009 to 2014. Analysis on the impact of New Medical Reform and other relevant factors on the operating efficiency of rural health service centres in Hami Prefecture. Provide Decision-making basis for Health Administrative Departments.MethodsHealth statistical yearbook of 2009 to 2014 was used to collect 37 rural health service centres’ relevant inputs and outputs. Ratio analysis was used to analyse average work efficiency.Use CCR model and BCC model of DEA to analyse static efficiency of rural health service centres of Hami Prefecture from 2009 to 2014.DEA-Malmquist index was employed to analyse changes in productivity from 2009-2014. Tobit regression and multiple linear regression analysis was used to analyse influence factor of operating efficiency.Results1. The amount of workers, the amount of basic medical services and the amount of basic public health services increased annually by 4.6%,4.0% and 31.0%. The total income and the total expenditure increased by the speed of 19.3% and 18.8%. 2.The average amount of total medical services showed changes after the first wave of lift during 2009 to 2013, then continue to decrease at 2014, overall rate of decline to 0.6%. From 2009 to 2013,equivalent method sum and direct sum all types of public health service ixdex, the average amount of public health services increased annually, overall rate of increment to 25.2% and 22.9%, but decreased at 2014. 3.During 2009 and 2014,in 37 Rural health service centres of Hami Prefecture, the number of technical efficiency, pure technical efficiency and scale efficiency of DEA effective changed little. The number of technial effciency of DEA effective is between 4 to 6,the proportion is between 10.8% and 16.2%. The number of pure technical efficiency of DEA effective is between 8 and 12, the proportion is between 21.6% and 32.4%. The number of scale efficiency of DEA effective is between 4 and 8,the proportion is between 10.8% and 21.6%.From 2009 to 2014, the number of rural health service centres which on the state of constant return to scale changed little, which is between 4 and 8. But the number of rural health service centres which on the state of increased return to sacle and decreased return to scale changed largely. The number of DMU which on the state of increased return to scale is between 1 and25,,the number of DMU on the state of decreased return to scale is between 7 and 30.From the view of input and output slack variable value, the main reasons for the low efficiency of the investment is the public health services and basic medical services insufficient. 4.The total factor productivity of rural health service centres of Hami Prefecture increased 0.6% during 2009 and 2014,which caused by the progress of technical efficiency(2.7%).Yearly analysis shows,The total factor productivity increased at the period of 2009-2010 and 2010-2011. The total factor productivity increased depended on technical efficiency at the period of 2009-2010, and which increased depended on technic improving at the period of 2010-2011. At the period of 2011-2014, in spite of annually improving technical efficiency, technic grogress declined annually, which caused the total factor productivity decreasing.Under the condition of the total factor productivity,there are 9 DMUs’ total factor produtivity increased and there are 28 DMUs’ total factor productivity decreased from 2013 to 2014.There are 3 DMUS’ technical efficiency increased and there are 32 DMUs’ technical efficiency decreased. At the same year, there are 36 DMUs’ technology improving and there are only 1 DMU decreased. Under the reason of the total factor productivity increasing, except the total factor producvity increased depend on technology improving at the period of 2010 to 2011, the total facor produtivity increased depend on technology efficiency at the other year. Under the reason of the total factor productivity decreasing, the total factor producvity decreased mainly caused by technology progress decline at the period of 2011 to 2014. 5. Factor model with full input and output indicators, based on the analysis results of Tobit regression panel data shows: the influence factors of technology efficiency contain the proportion of health technical personnel, Million more than the total value of the equipment, service population, the amount of public health services, basic health services, total revenue, total expenditure and the number of workers,among of them, total expenditure and number of workers have a reverse effect on technical efficiency.Conclusions1. For the rural health service centres of Hami Prefecture, internal management is not in place, lower health technicians technical level, the lack of general practitioners,the medical technology is relatively backward, with a lack of medical equipment,.With the same input, the rural health service centres largely ineffective public health service capacity and basic medical services provided in an amount insufficient to cause. 2. Because the calculated efficiency based on DEA method is relatively efficient, under equivalent method sum and direct sum all types of public health service ixdex established different model,operating efficiency analysis results are essentially the same. But taking into account the public health service indicators different units, and to facilitate investment analysis input and output slack variable values, when using the appropriate value will be representative of the public health service indicators are combined into a composite index more valuable. 3. Factors affecting technical efficiency analysis, to include input and output indicators whole factor model, based on the analysis results of Tobit regression panel data more accurately reflect the efficiency of factors.