Analysis On The Operating Efficiency Of Community Health Service Centers With Different Ownerships In Urumqi City

Objectives:To investigate the operational efficiency of the Community Health Service Centers,and compare the operational efficiency and productivity changes of different Community Health Service Centers in Urumqi from 2012 to 2016,Which providing decision-making basis for the health and family planning administrative department.Methods:Using the health statistics annual report data and on-site investigation data from 2012 to 2016 in Urumqi,the ratio method and data envelopment analysis(DEA)method was used to analyze the operational efficiency of Community Health Service Centers in Urumqi,the DEA-BCC model was used to analyze the static efficiency of the different main Community Health Service Centers respectively from2012 to 2016,and the DEA-Malmquist index model was used to analyze the dynamic efficiency from 2012to 2016.Results:1.The each Physician Responsible for Daily Clinic Visits Community Health Service Center increased from 9.2 in 2012 to 12.1 in 2016 in Urumqi.From the perspective of of different ownerships,the each Physician Responsible for Daily Clinic Visits in 2016 from high to low was enterprise-run(14.3person-times),the public hospital-owned(12.7 person-times),private(11.6 person-times)and the government-owned(8.6 person-times).The Each Physician Responsible for Daily Inpatient Bed Days of Community Health Service Centers increased from 0.8 bed days in 2012 to 1.0 bed days in 2014,and decreased to 0.7 bed days in 2016.From the perspective of different ownerships,The Each Physician Responsible for Daily Inpatient Bed Days in 2016 from high to low are the government-owned(0.8 bed days),the public hospital-owned(0.7 bed days),private(0.7 bed days),and enterprise-run(0.6 bed days).2.The number of Patients with Chronic Disease Standardized Management of the Community Health Service Centers increased from 25 in 2012 to 52 in 2016 in Urumqi.From the perspective of different ownerships,the number of Patients with Chronic Disease Standardized Management of the Community Health Service Centers in 2016 from high to low was the public hospital-owned(75 people),enterprise-run(52 people),private(33 people)and government-owned(31 people).The average annual number of elderly people over 65 years old is increased from 32 in 2012 to 44 in 2016.From the perspective of different ownerships,the average annual number of employees aged 65 and over in 2016from high to low was the public hospital-owned(76 people),enterprise-run(49 people),government-owned(27 people)and private(25 people)..3.The results of the DEA-BCC model analysis show that(the number of institutions varies from year to year).From 2012 to 2016,the total technical efficiency of the Community Health Service Centers in Urumqi was 41.2%(14/34)and 27.8%(10/36)respectively.25.7%(9/35),26.2%(11/42)and 10.9%(5/46),after testing,?~2=9.718,P=0.045,the difference was statistically significant,and the effective proportion decreased year by year;In terms of different ownerships,the total effective rate of total technical efficiency of Community Health Service Centers in 2016 from high to low was private 14.3%(2/14),the public hospital-owned 13.3%(2/15),and enterprise-run 9.1%(1/11)and government-owned0.0%(6/6).There was no statistically significant difference in the proportion of active centers(Fisher test,P=1.000)with government and non-government run facilities combining the public hospital-owned,enterprise-run and private to meet the R×C Chi-square test conditions.4.The results of the DEA-BCC model analysis show that based on 2012,the new Community Health Service Centers were excluded,the total technical efficiency ratios respectively were 45.2%(14/31)and32.3%(10/31)respectively.41.9%(13/31),38.7%(12/31)and 35.5%(11/31)from 2012 to 2016,after testing,?2=1.36,P=0.851,the difference was not statistically significant.From different ownerships,the total effective rate of technical efficiency of Community Health Service Centers in 2016 respectively was private 42.9%(3/7),enterprise-run 40.0%(4/10),and the public hospital-owned 37.5%(3/8)and government-owned(16.7%(1/6)).There was no statistically significant difference in the proportion of effective centers in the Community Health Service Centers of government and non-government run facilities(Fisher test,P=0.383).5.Using the same number of institutions from 2012 to 2016 to analyze the Malmquist index model,the results showed that the total factor productivity of the Community Health Service Centers in Urumqi increased by 1.3%.The results of the Malmquist index model analysis using the same number of institutions in 2015-2016 showed that the total factor productivity was 0.828.Compared with 2015,the total factor production efficiency decreased by 17.2%in 2016.Conclusions:1.More than half of the Community Health Service Centers in Urumqi have relatively insufficient efficiency,and the efficiency of community health service institutions needs to be further improved.2.There is no difference in the operational efficiency of different ownerships Community Health Service Centers.This is related to the Urumqi Municipal Health Planning Commission's development of a series of policies that are conducive to the development of Community Health Service Centers.3.The generally low operating efficiency of newly-opened community health service institutions indicates that health,finance,medical insurance and other departments should give more support policies to newly-opened primary health care institutions.