| In 2009,Fujian Province initiated the comprehensive reform of public hospitals.From 2011 to 2014,the reform at provincial level public hospitals was implemented.In 2015,the reform of urban public hospitals was fully implemented with the opportunity of being included in the national comprehensive reform of medical reforms."Deepen the reform of the medical and health system and establish a basic medical and health system,which has Chinese characteristics."Under the background of medical reform,it is particularly meaningful to find out the factors that can significantly affect the efficiency of hospitals by measuring the efficiency of public hospitals,and to make targeted improvements to these factors to improve the efficiency of the hospital.The purpose of this study is to explore the efficiency of hospital and its influencing factors.In this study,164 public hospitals in Fujian province are used as the observation objects,and the samples included 7 years data from 2009 to 2015.The input items are the actual open beds,the number of employees in service at the end of the year,fixed assets and total expenditures.The output terms are the number of discharged patients,the number of emergency patients and the utilization rate of beds.The CCR and BCC model of data envelopment analysis(DEA)are used to measure the efficiency of each hospital.After calculation,it is found that:1.in the period 2009-2015,the overall efficiency level and the scale efficiency level of the sample hospital are in the middle efficiency range and showed a downward trend.The technical efficiency level is in the high efficiency range,and the overall trend is increasing.The vast majority of sample hospitals are in a state of inadequacy.2.The differences between the comprehensive efficiency and scale efficiency of hospitals in various regions have significant significance.The comprehensive efficiency and scale efficiency of the first and second regional hospitals are higher than that of the third regional hospitals.However,there is no statistical significance in the difference between the comprehensive efficiency and the scale efficiency of the first type and the second category.3.The differences between the overall efficiency,technical efficiency and scale efficiency of each grade hospital have significant significance.The efficiency of provincial sample hospitals is higher than that of municipal sample hospitals.Secondly,using the Tobit regression model,it was found that the average number of emergency visits per employee had a positive effect on overall efficiency,technical efficiency,and scale efficiency,expenditures on staff accounted for the proportion of business expenses,and the number of turnovers on beds had a positive impact on overall efficiency and technical efficiency,the income from medicines and the average number of days hospitalized by hospital dischargers had a negative impact on scale efficiency.Then,combining the GM(1,1)model with the DEA model,predict the efficiency values of 10 provincial public hospitals in 2016.Among them,the technical efficiency is 0.926,the pure technical efficiency is 0.966 and the scale efficiency is 0.959.Taking the non-effective hospital DMU1 as an example,compared with the DEA effective hospital,the hospital has invested 6.26%more beds,22.11%of employees,12.69%of fixed assets,and 13.22%of total expenditure.Finally,based on the analysis,related background and policy guidance,suggestions for improving the efficiency of public hospitals’ economic operation are put forward.The innovation of this research is that it is the first time grey prediction and DEA method are combined to evaluate the efficiency and predict the future function.In addition,in this paper,index screening is done first,followed by cluster analysis. |
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