Evaluation On The Efficiency Of Township Hospitals In Chongzuo City From 2010 To 2015

Objective:Based on the underdeveloped areas,this paper aims to analyzes the basic situation of the township hospitals in Chongzuo City from 2010 to 2015,to evaluate the comprehensive efficiency and total factor productivity,to explore the influencing factors of comprehensive efficiency,and to provide suggestions for improving the efficiency of township hospitals in Chongzuo City.Methods:Taking the whole township hospitals of Chongzuo City as the research object,excluding the three new township hospitals and seven existing township hospitals that data are incomplete,the remaining 81 township hospitals included in the study,the panel data of households,beds,housing,equipment,medical services and public health services indicators of each town hospital in 2010-2015 are collected through the Chongzuo City Health and Family Planning Commission statistical annual report.The data envelopment analysis is used to evaluate the comprehensive efficiency and total factor productivity of Chongzuo township hospitals from 2010 to 2015,the panel Tobit model is used to analyze the factors of the efficiency.Results:(1)From 2010 to 2015,the number of workers,health technical personnel,registered nurses increased continuously,but the number of practitioners(assistants)decreased,decreased by 9.17%;The number of beds increased from 2242 to 2628;Township health service area increased from 193944m2 to 226201m2;The total value of equipment more than 10,000 yuan,the number of equipment more than 10,000 yuan showed a rapid growth trend,the compound growth rate reached 22.12%,9.64%;the compound annual growth rate of the number of clinics and the number of discharged in the township hospitals of Chongzuo City were 4.98%and 14.41%respectively.the compound annual growth rate of the number of standardized electronic of urban residents archives and the number of national immunization plan in 0-6 years old children were 35.45%and 3.86%respectively.(2)From 2010 to 2015,the comprehensive efficiency of the township hospitals in Chongzuo City increased from 0.657 to 0.738,in the past six years,DEA effective township hospitals were 17,21,19,19,25,20,the average was 20,the average proportion of was less than 1/4;Pure technical efficiency increased from 0.734 to 0.845,more than half of the township hospitals pure technical efficiency value were less than 1 in the six years;Scale efficiency decreased from 0.892 to 0.869,scale efficiency effective township hospitals were 19,21,20,19,26,22,the average was 21,the average proportion of was 25.93%,the health technical staff of the township hospitals which was scale increasing returns was significantly lower than the township hospitals which was scale same or diminishing returns in the six year.The average Malmquist productivity index of the township hospitals in Chongzuo City was 1.007 from 2010 to 2015,an average increase was 0.7%,among it,the technical efficiency change index increased by 3.8%,technological progress change index fell 2.0%,from the decision-making unit,40 township hospitals Malmquist productivity index weae less than 1,total factor productivity was declined.(3)Tobit regression results showed that rural residents' net income(yuan)(Z = 4.5543,P<0.0001)had a significant effect on the comprehensive efficiency of township hospitals,and positively correlated with comprehensive efficiency values.New rural cooperative hospital patient policy compensation ratio(%)(Z ?-2.1771,P = 0.0295)had a significant effect on the comprehensive efficiency of township hospitals,and negatively correlated with comprehensive efficiency.Conclusions:(1)The shortage of medical and health human resources is the main problem of the township hospitals in Chongzuo City.(2)The comprehensive efficiency of the township hospitals in Chongzuo City had small increase,but the overall situation was relatively low serious;the overall level of pure technical efficiency was lower than the scale efficiency,more than half of the township hospitals had been in the state of increasing the scale of human resources.The total factor productivity index of township hospitals in Chongzuo progressd slowly in the six years,which was mainly affected by the decline of technological progress index.(3)The net income of rural residents and the new rural cooperative hospital patient policy compensation ratio had a significant effect on the comprehensive efficiency values of township hospitals.