北京市二级公立综合医院适宜规模研究

摘要

Objective To analyze the optimal scales of secondary public hospitals so as to optimize the expansion of public hospitals.Methods Forty-six secondary public general hospitals in Beijing were selected as the sample,with input and output indicators pinpointed,for analysis of the status of economic return to scale of such hospitals from 1996 to 2012,and identification of inflexion points of the returns to scale.These efforts will help find an optimal scale of such hospitals.Resalts The period from 1996 to 2012 found the general effectiveness of such hospitals in a decline.In 2012,only 4 of the 46 hospitals were in DEA effectiveness status,and the other 42 hospitals were not; Forty-three inflexion points were identified.This study found that the strict control standards for secondary public general hospitals in Beijing were 298 beds and 585 staffs; the flexible control standards were 421 beds and 807 staffs.Conclclsion The optimal scales for secondary public hospitals were drown from the analysis,for references of other regions in China.The hospitals should prioritize resources efficiency instead of scale expansion.%目的 研究二级公立综合医院床位和人员的适宜规模,控制公立医院扩张速度.方法 以46家北京市二级公立综合医院为研究样本,确定投入和产出指标,分析1996年至2012年各医院规模报酬状态,找出规模报酬拐点,确定二级公立综合医院的适宜规模.结果 各医院在1996年至2012年间,总体效率呈现衰减状态.2012年,46家医院中,仅有4家医院处于DEA有效状态;确定规模报酬拐点43个,二级公立综合医院适宜规模的严格控制标准为床位298张、在职职工数585人;宽松控制标准为床位421张、在职职工数807人.结论 研究得到了北京市二级公立综合医院的床位和人员规模控制参数,可供全国其他地区参考.医院管理的优先重点是提高资源利用效率,而不是规模扩张.