Evaluation Of The Operational Efficiency Of Shanghai Municipal Hospital With Data Envelopment Analysis

Background: The medical and health industry is one of those closely related to the well-being and productivity of the whole population.Health care in our country has been developing rapidly due to the growing attention and investment from the government.In recent years,a series of policy documents issued clearly pointed out that it was needed to improve the efficiency of hospital operation and to establish a modern hospital management system.As the pioneer of health care reform,hospitals in Shanghai adopted experience from modern enterprises.Objective evaluation of the operational efficiency of hospitals,and analyses of its change and associated influence factors can provide not only a starting point for hospital managers,but also a reference for rationally allocation of resources.Object: The present study analyzed the current situation and the operational efficiency of the 28 municipal hospitals in Shanghai from 2012 to 2015,with the use of the C2 R model,BC2 model and Malmquist index model in data envelopment analysis(DEA).Method: The data in this study were obtained from Shanghai Shenkang Hospital Development Center.The 28 hospitals included 11 general hospitals and 17 specialized hospitals.Articles regarding the theories,methods,and results on the evaluation of hospital efficiency with DEA were collected.Based on these studies,the frequency of the input and output variables used were calculated.The variables included were determined after consultation and statistical analyses like cluster analysis,correlation test,and calculation of coefficient of variation.Descriptive analyses and DEA,as well as Malmquist analysis were performed.The software utilized were Microsoft Office Acess 2013?SPSS 17.0?Max DEA 6.17,and DEAP 2.1.Results: According to the analyses performed,the variables finally included were total number of employees,actual commendations,expenditure in health care,cost per visit for outpatient,cost per visit for inpatient,number of outpatients,number of inpatients,revenue charges,cost for outpatients,cost for inpatients,and average length of stay.The whole performance of the 28 municipal hospitals in Shanghai were fairly good from 2012 to 2015.The total number of employees,actual commendations,and the total assets of the 28 hospitals all increased steadily.The number of outpatient had a steady increase,and the number of inpatient expanded significantly.The costs continued to be optimized,basically consistent with the trend of health care services.The proportion of costs related with drugs continued to decline.The average length of stay continued to decline,with accelerated turnover.The number of outpatients per capita,the number of inpatients per capita,and the number of surgeries performed per capita were all increased.In this study,we chose two from 13 indicator systems based on discrimination power,robustness,and information gained to distinguish the most inefficient and the most efficient hospitals.The significant correlation between the two models suggested that they were both correct and appropriate.The number of efficient units were 5,4,6,and 5,while the numbers of insufficient hospitals were 12,7,9,and 10 from 2012-2015.In the context of Model 3,the average technical efficiency in 2012-2015 were 0.78,0.747,0.774,and 0.776,respectively.In the context of Model 11,they were 0.941,0.903,0.940,and 0.941.Consequently,in general,the overall operational efficiency of the 28 municipal hospitals in Shanghai in 2012-2015 was high.Malmquist analysis showed that the ‘total factor productivity change' of the 28 hospitals was increasing in 2012-2015.Additionally,it was profoundly affected by technical improvement.However,the ‘technical efficiency' dropped a little,with no change in ‘scale efficiency'.Based on the above calculation and analyses,we suggest Shanghai municipal hospitals to take their advantages in scientific and technological innovation,to adapt to the new situation of reform in health and economics,and to improve hospital management with professional personnel,modern concepts and advanced techniques.The ultimate goal is to achieve the control of cost and expenditure,to improve resource utilization and operational efficiency,therefore,to enhance the capacity and quality of health care services.The results of this study can provide reference to the practice of hospital management with an evaluation of hospital operational efficiency.