| ObjectiveData envelopment analysis(DEA)was used to evaluate the efficiency characteristics,productivity changes and the factors affecting the efficiency of 15 tertiary maternal and child health hospitals with the same scale size and 36 tertiary general hospitals in China with the same scale size in 2012-2016,to provide some scientific basis for the efficiency improvement of sample hospitals.MethodsUse C2R-DEA model,Super-C2R model,BC2-DEA model,Super-BC2 model and Cost-DEA model to calculate the technical efficiency,super technical efficiency,pure technical efficiency,super pure technical efficiency,scale efficiency,cost-efficiency and allocative efficiency of sample hospitals,and use Malmquist productivity index model to calculate the productivity and efficiency changes of the sample hospitals during the period of 2012-2016.Use the software DEAP2.1 and DEA SOLVER(LV3.0)to calucate the DEA efficiency.Statistical analysis mainly include statistical description and multiple regression analysis,use software SPSS 17.0 to calucate these statistical analysis.ResultsPart one:sample maternal and child health hospitals1.During 2012 to 2016,there were an average annual increase of 6.06%in employees of sample maternal and child health hospitals,an average annual increase of 11.83%in practicing physicians,an average annual increase of 10.03%in beds,an average annual increase of 10.01%in outpatient visits,an average annual increase of 10.56%in discharged patients,an average annual increase of 2.91%in outpatient visits per worker,an average annual increase of 3.87%in discharge per worker,an average annual increase of-0.72%in hospital bed turnover,an average annual increase of-2.78%in average day of hospitalization,an average annual increase of 16.16%in medical income,an average annual increase of 12.52%in drug income,an average annual increase of 17.01%in gross income,an average annual increase of 15.99%in gross charge,an average annual increase of 23.28%in balance of revenue and expenditure.2.The evaluation model of sample maternal and child health hospitals was set by the number of practitioner,the number of beds,the number of discharges and the number of outpatient visits.The model was scientific and reasonable.3.The average technical efficiency of 15 sample maternal and child health hospitals ranged from 0.85 to 0.89 during 2012 to 2016.1n the same period,the average of pure technical efficiency for the sample hospitals ranged from 0.91 to 0.95,the average of scale efficiency for the sample hospitals ranged from 0.92 to 0.95,and the trend of the scale efficiency and the technical efficiency was consistent completely.4.From 2012-2016,33.33%-53.33%of the sample maternal and child health hospitals were in the stage of the decreasing returns to scale,and 6.67%-20.00%of the sample hospitals were in the stage of the increasing returns to scale.5.The Malmquist productivity index model results showed that the technical efficiency of the sample maternal and child health hospitals has increased by 0.5%in annual average during the period of 2012 to 2016,the technical level has been reduced by 0.7%annually,the pure technical efficiency has increased by 0.5%on annual average,the scale efficiency has declined by 0.1%on annual average,and the total factor productivity has declined by 0.2%on annual average.6.To increase the number of bed turnover can improve the TE,PTE and SE of sample maternal and child health hospitals;To increase the number of hospital discharges per employee and the number of visits per employee can improve the TE and SE of sample hospitals;Reduce the average hospital cost of patients can improve the SE;improve the hospital bed day for each employee can improve the PTE of the sample hospitals.Part two:sample general hospitals7.During 2012 to 2016,there were an average annual increase of 5.27%in employees of sample general hospitals,an average annual increase of 6.01%in practicing physicians,an average annual increase of 5.04%in beds,an average annual increase of 7.56%in outpatient visits,an average annual increase of 9.48%in discharged patients,an average annual increase of 0.92%in outpatient visits per worker,an average annual increase of 3.36%in discharge per worker,an average annual increase of 7.09%in hospital bed turnover,an average annual increase of-3.61%in average day of hospitalization,an average annual increase of 18.52%in medical income,an average anrnual increase of 10.25%in drug income,an average annual increase of 12.98%in gross income,an average annual increase of 13.39%in gross charge,an average annual increase of 3.24%in balance of revenue and expenditure.8.The output indicators are the number of discharges and the number of outpatient visits.And the input indicators are the number of employees and the number of beds.The model is scientific and reasonable.9.From 2012 to 2016,the average technical efficiency of the sample general hospitals was 0.78 to 0.82.In the same period,the average pure technical efficiency of the sample hospitals was 0.84 to 0.87,the average scale efficiency was 0.90 to 0.95,the pure technical efficiency was less than the scale efficiency.10.From 2012 to 2016,41.67%-77.78%of sample general hospitals were in the stage of the decreasing returns to scale,8.33%-50.00%of sample hospitals were in the stage of the increasing returns to scale,almost of them were in ineffective scale efficiency because of oversize.11.The Malmquist productivity index model results showed that the technical efficiency of the sample general hospitals in 2012 to 2016 decreased by 0.9%in annual average,the technical level increased by an average of 3.9%,and the total factor productivity increased by 3.0%annually.12.To increase the turnover of hospital beds can improve the AE and CE of sample hospitals;to increase the number of hospitalizations per employee can improve the TE,PTE,AE and CE of sample hospitals;to increase the number of visits per employee can improve TE,PTE and CE of sample hospitals;to increasing pharmaceutical revenue can improve the TE of sample hospitals;to reduce average patient hospitalization days can improve the TE,PTE,AE and CE of sample hospitals;to reduce the average cost of patients hospitalization can improve the TE and SE of the sample hospitalS;to increase the hospital bed days per employee can improve the PTE and AE of the sample hospital.Conclusions1.The scale of the sample maternal and child health hospitals and the sample general hospitals has expanded year by year in 2012-2016 years.Most of the sample general hospitals and the sample maternal and child health hospitals were in the scale efficiency ineffectiveness status,and almost of them were in ineffective scale efficiency because of oversize.2.The trend of scale efficiency and technical efficiency was consistent of sample maternal and child health hospitals,the scale was a key influence factor for technical efficiency,the pure technical efficiency of the sample general hospitals was lower than the scale efficiency.Obviously,it showed that the sample general hospitals still has great improvement space in improving its management level,playing the role of technical level and optimizing the organization structure.The scale is an important factor affecting the allocation efficiency of the sample general hospitals,the allocation efficiency has changed significantly when most of the sample hospitals have scale adjustment remarkablely.3.The total factor productivity of the sample maternal and child health hospitals almost nothing changed since 2012 to 2016.The total factor productivity of sample general hospitals has increased by 3.0%,the technical changed has improved productivity obvious. |
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