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我国医院效率评价研究现状

     

摘要

This paper analyzed the present situation on efficiency in hospitals and reasons for the failure of im-plementation. The analysis found that the research experienced a stage of fragmentation-dualization-systematic phase. The research subjects mainly included integrated or general hospitals (84. 21% ), hospitals of Grade II or above (55. 79% ), mixed and local systems (95. 26% ), and public hospitals dominated with 97. 89% , all of the subjects being covered from 22 provinces and municipalities. The comprehensive, technical and pure technical efficiencies had propor-tions of 87. 89% , 68. 84% and 86. 84 respectively and were concentrated in the research content, the evaluation meth-od being mainly DEA and and/or BCC (67. 89% ). The selection of indicators was mainly qualitative (47. 36% for pure literature analysis) and the main indicators were almost internally set. The first three were used in the frequency divi-sion outpatient emergency number (55 visits), number of beds and fixed assets (44) and total expenditures (42). The main sources of data were public access (27. 89% ), internal data (31. 05% ), investigations or various surveys (30. 53% ) and the hospitals’ own data reports (15. 26% ), and more than half (54. 21% ) was single road. Conclusion:The hospital efficiency evaluation focused on the integrated public hospitals above the grade two, mainly based on the relative efficiency of DEA, which involves many contents, wide geographical area and large span but the selection of in-dicators, data sources, and quantification of factors still restrict the quality of the results. The imbalance between the needs of researchers and managers for efficiency evaluation, inadequate understanding ad unbalanced knowledge togeth- er with the lack of relevant policies hindered the transformation of results. Therefore, the consistent mechanism for hospi-tals efficiency evaluation should be established from the angle of top-level design and actual situation of hospitals in China.%通过对我国医院效率评价实证研究文献进行筛选和计量分析发现,研究经历了碎片化—双元化—规模化的阶段;研究对象以综合医院、二三级混合医院、地方系统、公立医院为主;研究内容集中于综合效率、技术效率、纯技术效率方面;评价方法以DEA的CCR和(或) BCC为主;指标选择以定性为主(如: 纯文献分析占47.36% ) ,且主要指标几乎为内因设置,使用频次排前3位的是:门急诊人次、床位数和固定资产、总支出;数据来源主要有公开获得、内部资料、各种调查、医院自报,且54.21%为单一渠道.医院效率评价聚焦于二级以上综合公立医院, 主要以DEA相对效率为主, 涉及内容多、地域广、跨度大.但指标选择、数据来源、因素量化等仍制约成果质量,研究者和管理者对效率评价的需求不平衡、认识不充分、知识不对等以及相关政策缺乏共同阻碍了成果转化,需要从顶层设计上建立符合我国医院实情的效率评价机制.

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