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目的:比较分析重庆市不同类型县级公立医院运营效率,并测算效率损失程度、探究效率损失根源。方法:利用重庆市2012—2014年医疗机构主要指标汇编数据,运用非参数共同前沿方法进行分析。结果:在共同前沿条件下,综合医院和中医院运营效率得分均值为0.742和0.719,差异具有统计学意义(P<0.05);在组别前沿条件下,综合医院和中医院运营效率得分均值为0.754和0.790,差异具有统计学意义(P<0.05)。综合医院组内组别前沿和共同前沿运营效率得分均值为0.758和0.742,差异具有统计学意义(P<0.05);中医院组为0.790和0.682,差异具有统计学意义(P<0.05)。综合医院和中医院技术落差比率均值为0.984和0.863,差异具有统计学意义(P<0.05)。综合医院和中医院无效率得分均值为0.258和0.318,差异无统计学意义(P>0.05)。技术无效率和管理无效率对综合医院效率损失的贡献度分别为4.64和95.36,中医院为33.99和66.01。结论:重庆市县级公立医院显著存在技术异质性特征,并且不同类型县级公立医院技术异质性表现程度存在显著差异;综合医院效率损失主要来源于落后的管理水平,中医院由生产技术水平和管理水平双重因素所致。
Objective: To compare and analyze the operational efficiency of different types of county-level public hospitals in Chongqing, and to estimate the degree of efficiency loss, so as to explore the causes of loss of efficiency. Methods: According to the compilation data of major indicators of medical institutions in Chongqing from 2012 to 2014, the non-parametric common frontier method was used to analyze. Results: Under the common frontal conditions, the average scores of operational efficiencies in general hospitals and Chinese medicine hospitals were 0.742 and 0.719, respectively, and the differences were statistically significant (P <0.05); under the frontier conditions, the average scores of operational efficiency in general hospitals and hospitals were 0.754 and 0.790, the difference was statistically significant (P <0.05). The mean scores of frontal and frontier operational efficiency in the general hospital group were 0.758 and 0.742, respectively, with statistical significance (P <0.05). The Chinese hospital group was 0.790 and 0.682, with statistically significant differences (P <0.05). The technical drop ratios of general hospitals and Chinese medicine hospitals averaged 0.984 and 0.863, respectively, with significant differences (P <0.05). The scores of inefficiency in general hospitals and Chinese medicine hospitals were 0.258 and 0.318, respectively, with no significant difference (P> 0.05). The contribution of technical inefficiency and management inefficiency to the efficiency loss of general hospitals were 4.64 and 95.36, respectively, and that of Chinese medicine hospitals was 33.99 and 66.01 respectively. Conclusion: There are obvious characteristics of technical heterogeneity in county-level public hospitals in Chongqing, and there are significant differences in the performance of technical heterogeneity among different types of county-level public hospitals. The efficiency loss of general hospitals comes mainly from the backward management level. Level and management level due to double factors.