Efficiency And Changes Research Based On The DEA Model Of Hospital Departments

ObjectiveConstruct evaluation models with the method of screening out simple and practical hospital departments efficiency index evaluation system. In the empirical analysis, these models were evaluated in the departments efficiency and change of situation for one Class III Comprensive Hospital in Hunan province in the period 2010-2013, in order to provide scientific decision-making basis for improving the efficiency of the hospital departments and perfecting the evaluation model of hospital performance.MethodEstablishing an excel database which is based on systematic collection from the data related to the various departments of sample hospital during 2010-2013,and using cluster analysis method to classify the data index from the database. Statistical description for single factors is by SPSS 18.0. We analyzed department efficiency and changes using different kinds of DEA approaches such as the C2 R and BC2 models, as well as the Malmquist DEA models, using DEAP software(version 2.1).Results 1. Bibliometric analysis shows that the most frequently used input indicators are the: total number of beds, total number of staff, total expenses, value of fixed capital, physicians(PHYS), and other clinical staff(CLIN). The most frequently used output indicators are the: number of outpatient and emergency visits, number of hospitalize versus discharged patients in the clinic, total patient revenue, average of hospital stay, and total number of operations.2. Cluster analysis indicates that input indicators are divided into three categories. The first category is composed of: physicians(PHYS), total number of staff, total number of beds. The second category refers to the value of fixed capital. The third category refers to total expenses. The output indicators are divided into two categories. The first category is composed of the: number of hospitalized-discharged patients in the clinic, total patient revenue, and average of hospital stay. The second category refers to outpatient and emergency visits.3. The input indicators for Clinical Departments are the total number of staff and total expenses. The output indicators for Clinical Departments are the total patient revenue and the number of outpatient and emergency visits. The input indicators for Medico-Technical Departments are the total number of staff and the value of fixed capital. The output indicators for Medico-Technical Departments are the total number of tests and total patient revenue.4. The hospital clinical departments technical efficiency from 2010 to 2013 showed a trend of rising(0.572 ~ 0.604), accounting for 15% of the effective sections. Pure technical efficiency fluctuated between 0.709 ~ 0.738, accounting for 21% of the effective sections. The overall scale efficiency increased from 0.799 to 0.826, where the effective department accounted for 15 percent.5. Technical productivity for Medico-Technical Departments fluctuated between 0.640 and 0.702(from 2010 to 2013), where the effective department accounted for 16.5 percent. Pure technical efficiency fluctuated from 0.792 to 0.839, where the effective department accounted for 27.8 percent. The overall scale efficiency fluctuated from 0.785 to 0.825, where the effective department accounted for 16.5 percent.6. Clinical Departments demonstrated increasing returns to scale in 49 percent of the Decision Making Unit(DMU) between 2010 and 2013. Constant returns to scale accounted for 15 percent of the DMU. Decreasing returns to scale were observed in 36 percent of the DMU. For Medico-Technical Departments, increasing returns to scale accounted for 61 percent of the DMU between 2010 and 2013. Constant returns to scale accounted for 22 percent of the DMU. Decreasing returns to scale were observed in 11 percent of the DMU.7. For clinical departments the change in productivity index is greater than 1 between 2011 and 2013; likewise, the changes in technical efficiency is greater than 1 in 2011 and 2013; however change in the technical efficiency index was less than one in 2012. Technical changes are greater than 1 between 2011 and 2012.Technical change index was less than 1 in 2013.8. For medico-technical departments the change in the productivity index is greater than 1 between 2011 and 2013; likewise, the changes in the technical efficiency index is greater than 1 between 2011 and 2012. However, changes in the technical efficiency index was less than 1 in 2013, this implies that productivity declined from the previous year. Technical change index is greater than 1 between 2011 and 2013, thus increasing each year.9. The constituent ratio of efficient medico-technical departments was greater than for the clinical departments in technical efficiency, pure technical efficiency, and scale efficiency. The constituent ratio of constant returns to scale for medico-technical departments was greater than for clinical departments.Conclusion 1、For clinical departments, the input indicators are composed of the total number of staffed and total expenses, while the output indicators include the number of outpatient and emergency visits and total patient revenue. For medico-technical departments, the input indicators are composed of the total number of staffed and the value of fixed capital, while the output indicators include the number of tests and total patient revenue. Both models have good operability and are representative.2. In terms of productivity performance, medico-technical departments appear to have achieved higher performance than clinical departments on average between 2010 and 2013. Although the overall level of technical efficiency is generally lower for clinical departments than for medico-technical departments, clinical departments improved year-to-year between 2010 and 2013. Even though clinical departments show a year-to-year increase in pure technical efficiency, this still accounts for lower levels of overall efficiency. Furthermore, the technical efficiency for medico-technical departments decreased slightly between 2010 and 2013. For medico-technical departments, there is little difference between the pure technical efficiency and scale efficiency in contributing to technical efficiency.3、The total factor productivity of clinical departments increased year by year during 2010-2013, but does not have stable efficiency or technical advantage; the total factor productivity of medico-technical departments increased rapidly, but the effect of the efficiency factors gradually declined over time, and technical factors on the sample hospitals medico-technical departments productivity shows a good role in promoting.