基于DEA模型的军队综合性医院床位适宜规模实证研究

摘要

Objective To evaluate the technical efficiency and scale efficiency of military comprehensive hospitals in order to make an empirical study on the suitable number of hospital beds .Methods Input and output indicators of 40 military comprehensive hospitals from 2001 to 2010 were collected, including staff, equipment, property, the amount of medical services .The Banker ,Chanes and Cooper ( BCC) model of Data Envelopment Analysis ( DEA) was used to analyze the status of returns to scale in different output index groups .Results Analysis results of the two groups showed that hospital beds averaged about 790 at the increasing return to scale ( IRS) stage, 1015 and 1098 at creasing returns to scale (CRS) stage, respectively,and that the average number of beds at the decreasing returns to scale (DRS) stage and CRS stage was similar.There were significant differences between IRS ,DRS and CRS stage.Conclusion The bed size at the CRS stage is about 1000 .Hospital beds can be increased to the proper number through the establishment of a hierarchical medical system and dual referral system .%目的：采用数据包络分析（data envelopment analysis，DEA）模型评价军队综合性医院的技术效率和规模效率，对医院床位适宜规模进行实证研究。方法收集40家军队综合性医院2001～2010年人员、设备、资产、医疗服务量等投入产出指标，运用DEA的BCC（Banker，Charnes and Cooper ）模型分析两组不同产出指标的样本医院规模收益状态，统计不同规模收益情况下的医院床位数。结果两组分析结果均显示，规模收益递増（ IRS）的医院平均床位约为790张，规模收益不变（ CRS）的平均床位分别为1015和1098张，规模收益递减（ DRS）的平均床位与收益不变的床位相似，不同规模收益状态之间均有显著性差异。结论床位规模在1000张左右的样本医院规模收益不变，可通过建立切实可行的分级诊疗和双向转诊制度促使医院的床位达到适宜规模。