【摘要】 目的:分析2003～2007年四川省县级及以上公立医院的技术效率和成本效率;比较数据包络分析方法在医院不同效率评价过程中的应用,为该方法在我国医院效率评价方面的应用提供参考建议。方法:采用数据包络分析评价四川省公立医院2003-2007年的技术效率和成本效率,采用秩相关分析探讨数据包络分析不同模型和指标在评价医院效率时是否具有一致性。结果:CRS模型所得技术效率值为0.758,VRS模型所得总技术效率值为0.758,纯技术效率值为0.800。CRS模型和VRS模型分别所得成本效率值为0.467和0.508,二者相关系数为0.957。DEAP2.1软件在测算技术效率和成本效率过程中都可得到技术效率值,二者相关性较高。有无平均住院日指标所得技术效率的相关系数为0.968,二者所得成本效率的相关系数为0.977。结论:在只关注医院总技术效率时应选用CRS模型,同时关注总技术效率、纯技术效率和规模效率时应选用VRS模型;无法确定所有医院都处于最优规模时,选用VRS模型评价医院成本效率为宜;不推荐采用成本效率测算过程中所得技术效率作为医院的技术效率评价结果;指标需经过统计检验并结合专业知识谨慎取舍。更多还原

【Abstract】 Objective To analyze the technical efficiency (TE) and cost efficiency (CE) of all the public hospitals at the county level and above from 2003 to 2007,compare the application of data envelopment analysis (DEA) in evaluating different public hospitals’ efficiencies,and provide reference to apply DEA in evaluating hospitals’ efficiency. Methods TE and CE of all the public hospitals at the county level and above from 2003 to 2007 were evaluated by DEA. The concordance of efficiency values derived from different models and indexes of DEA was studied by rank correlation analysis. Results TE value derived from constant returns to scale (CRS) model was 0.758,while that derived from variable returns to scale (VRS) model was 0.800. CE value derived from CRS model and VRS model were 0.467 and 0.508 respectively. The correlation coefficient (R) of the two CE values was 0.957. R of the two TE values derived from indexes including average length of stay (ALOS) and indexes excluding ALOS was 0.968,while that of the two CE values derived from indexes including ALOS and indexes excluding ALOS was 0.977. Conclusion It is suggested to choose CRS model when only TE is concerned. VRS model should be chosen when TE and scale efficiency are concerned simultaneously. It is appropriate to select VRS model to evaluate CE while not all the hospitals are in the optimal scale surely. TE derived from the CE measurement processes are not recommended as the evaluation results of TE in hospitals.更多还原