Research On The Operation Efficiency Of Tianjin Community Health Service Center Based On DEA-Tobit Model

As an important service carrier,the Community Health Service Center provides primary health care,such as the treatments of common diseases and frequently-occurring diseases,basic public health services,family planning technical services,health management,initial on-site first aid and referral of critically ill patients.Improving the operational efficiency of community health service centers has a great importance for residents to enjoy equalization of primary health care services.Due to the population aging rate is increasing in China,residents’ demand for community health services is increasing as well.Community health service center is becoming more acceptable in China.However,the operational efficiency of community health service centers is quite low,due to the shortage of investment and medical technicians,and unreasonable allocation of medical and health resources.Therefore,it is important to analyse and evaluate the efficiency level and other influencing factors which may be essential for improving the operational efficiency of community health service centers,promote the reform of the medical and health system,and provide the people with the full benefits.In addition,Azimuth and full-cycle health services also have practical significance.This paper will evaluate the operational efficiency level of community health service centers and their influencing factors by using the DEA-Tobit model and taking 24 examples of community health service centers in Tianjin.The results of DEA evaluation in this study are as follows: in terms of comprehensive technical efficiency,there are 8 community health service centers with comprehensive technical efficiency values of 1,which have an effective rate of 33.3%;the comprehensive technical efficiency value of 16 community health service centers is less than 1.In terms of pure technical efficiency,there are 13 community health service centers with a technical efficiency score of 1,and their effective rate are 54.2%.Moreover,there are 11 community health service centers and their effective rate are less than one.In terms of scale efficiency,a total of 8 community health service centers have a scale efficiency value of 1,which has reached an effective scale with an effective rate of 33.3%.The remaining 16 non-scale effective community health service centers have no incremental income.The Tobit regression results showed that six endogenous variables included the number of medical technicians,financial aid income,number of beds,and bed occupancyrate,are statistically significant at the 5% level,while the proportion of medical staff and the proportion of drug income to medical income are not statistic significant(P>0.05).In addition,only one variable which is community population,and it is statistically significant at the 1% level,besides,community financial income and community area are not statistic significant.In conclusion,with the existing investment scale of 24 community health service centers in Tianjin,the revenue of most community health service centers did not perform as expected,which means there is a phenomenon of imbalance between input and output.There are five reasons of the low operating efficiency of the 24 community health service centers in Tianjin: firstly,the community health service center has relatively insufficient resources;secondly,the number of employees in the community health service center is insufficient.Thirdly,the total expenditure of the community health service center is not enough.Fourthly,the community health service center lacks medical resources,the utilization efficiency of the input is not high,and there is a redundancy.Fifthly,the bed is insufficient and the usage rate of the bed is low.There are several suggestions,firstly,optimizing the allocation of medical and health resources in community health service centers;secondly,strengthening the construction of medical and technical personnel in community health service centers;thirdly,innovating the cost input mechanism of community health service centers;fourthly,increasing the number of the bed in community health service centers;fifthly,implementing the “six-in-one” construction in community health service center.