The Study Of The Economic Efficiency Of Scale And Its Determinants In County Public Hospital

ObjectiveCounty hospitals in towns and townships are linked together with the provincial,city general hospitals,is the county health care center and business guidance center,in the rural health service system plays a leading and core role.this study based on social and economic development level,population characteristics,the crowd around the health status and needs,and so on and so forth reasonable is used to determine the county-level hospitals of suitable size,on the basis of the results and conclusions,proposes the correspondingcountermeasuresandpolicySuggestions,toprovide decision-making reference for healthy development of the hospital,in Meizhou government provide theoretical basis for reasonable distribution of health resources.MethodsThrough the literature method,field survey method to collect relevant data,such as size of Meizhou and county public hospitals at the present stage situation of descriptive statistical analysis,analysis of Meizhou and county public hospital scale development characteristics and trends of Meizhou and county public hospital scale are studied by using factor analysis and the correlation between financial risk,and calculated the financial points of the public hospitals at the county level,a preliminary definition of Meizhou and county public hospital proper size.Using the method of data envelopment analysis?DEA?samples in Meizhou hospital for relative efficiency analysis,including the comprehensive efficiency,technical efficiency and scale efficiency and scale reward situation from four aspects,using the Malmquist index analysis calculates the total factor productivity at the hospital.By carrying out the Delphi expert consultation method,the indexes of the scale of county-level public hospitals were established,and the weight of the influencing factors was calculated,and the influencing factors were further discussed and analyzed.ResultsFrom 2014 to 2016,the number of actual open beds in 25 county-level public hospitals in Meizhou increased year by year,the gap was wide and the development level was polarized.In addition,the overall distribution of the beds of county-level public hospitals in the past three years shows a trend of right-skewed distribution,and there is a tendency to further expand the scale.The empirical research results show that the calculation formula of the financial situation of hospitals is as follows:F=33.61%F₁+22.996%F₂+21.149%F₃There is a five-power curve regression relation between the actual open bed number and the financial status of the public hospitals in meizhou city,and the regression equation is as follows:y=-6E-13x⁵+1E-09x⁴-9E-07x³+0.0003x²-0.0369x+1.1578When the actual open beds of county-level public hospitals are between100 and 310,the financial operation status of hospitals is positively correlated with the actual open beds,and the more beds,the lower the financial risk.When the actual open bed number of county-level public hospitals reaches310,it is the best financial position and the lowest financial risk.The actual open beds expanded from 310 to 540,during which the hospital's financial operation was negatively correlated with the actual open beds,and the more beds,the higher the financial risk.When the number of county-level public hospitals exceeded 540,the regression curve rose again,and the hospital financial situation gradually improved.In Meizhou City-level public hospitals,there are economies of scale in TCM hospitals,there are no economies of scale in maternity and child care centers,and the technical progress value of Dapu County People's Hospital is close to 2.Meixian District Chinese Medicine Hospital,Dapu County TCM Hospital,Fengshun County People The technical efficiency of these three hospitals did not change significantly,and the technical progress of the remaining 21 hospitals was less than one.4.Research on the influence factors of hospital scale.this study adopt expert consultation method to draw five important factors influencing hospital scale,weight sorting,respectively is:the hospital internal factors?about 21.4%?,policy resources factors?about 21%?,the competitive environment factors?about 19.4%?,economic factors?about 19.1%?,social factors?about 18.9%?.ConclusionThis study preliminarily concluded that the public hospitals at the county level in Meizhou need to be further improved in terms of top-level design of strategic planning,technical and service capabilities,resource support,and internal management.It is possible to establish a reasonable financial compensation mechanism,introduce foreign aid,and improve hospital leadership decision-making mechanisms.The scale of the hospital needs to be appropriately adjusted according to the type of hospital and the regional health resource planning,and the methods such as the number of hospital beds,the number of doctors,and the number of medical equipment should be properly controlled and expanded to further improve and enhance the scale economic efficiency of the hospital.