| 引用本文: |
仇蕾洁,马桂峰,张雪文,等.山东省不同类型社区卫生服务站医疗资源配置效率评价研究[J].中国卫生经济,2017,(12):70-74.[点击复制] |
.Assessment of Medical Resource Allocation Efficiency in Various Community health service stations[J].CHINESE HEALTH ECONOMICS,2017,(12):70-74.[点击复制] |
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| 摘要: |
| 目的：探讨在社会办医多元化的背景下，山东省2015年不同类型社区卫生服务站医疗资源配置效率情况。方法：利用数据包络分析，对山东省16个地市1246家9类社区卫生服务站进行总体效率、技术效率和规模效率评价。结果：社区卫生服务站总体效率有效占比为9.31%。有5类机构占比高于均值，多为医疗机构举办。其中，一级医院和乡镇卫生院转型的社区卫生服务站总体效率有效占比高达58.33%和60.00%；总体技术有效占比为23.27%，77.78%的社区卫生服务站技术有效占比高于均值。医疗机构和企事业单位举办的社区卫生服务站占比最高，但内部占比相差悬殊；总体规模有效占比为9.31%，55.56%的社区卫生服务站规模有效占比高于均值，三级医院延伸、企业高校和个人举办的社区卫生服务站规模有效占比明显偏低。技术有效同时规模无效的规模报酬递增均数占比为59.31%；规模有效同时技术无效又规模报酬递增的社区卫生服务站基本没有；规模无效约占全部社区卫生服务站的82.99%，明显高于技术无效占比的64.93%，严重影响总体效率。结论：医疗机构举办的社区卫生服务站在医疗卫生服务落实方面略好于其他类型社区卫生服务站，但内部效率占比相差悬殊，其他类型落实效果差异不大；一级医院和乡镇卫生院转型的社区卫生服务站用最少医疗投入获得最大服务产出，更适应基层医疗服务发展的需要；政府需要改变社区医疗卫生服务的投入模式，变“提供服务”为“购买服务”，打破行业隶属关系的限制；医疗机构举办的各类社区卫生服务站医疗资源配置效率的对比，对当前大中型医疗机构争相举办各类医联体有较好的警示作用。 |
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| Assessment of Medical Resource Allocation Efficiency in Various Community health service stations |
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| Abstract: |
| Objective: Under pluralistic social medicines, to explore changes of medical resource allocation efficiency in Shandong different kinds of community health service stations in 2015. Methods: Questionnaire method was used to analysis data about 1246 community health service stations of 9 types in 16 cities in Shandong province. The analysis included overall efficiency, technical efficiency and scale efficiency evaluations. Results: The overall effective rate of Community health service stations was 9.31%, which were more concentrated in stations run by medical institutions. Five types of stations’ effective rates were higher than the average. Among them, the overall effective rates of stations transformed by primary and township hospitals were up to 58.33% and 60.00%. The overall technical effective rate was 23.27%, 77.78% stations’ values were higher than it. Community health service stations held by medical, enterprise and public institutions had the highest proportion, however, internal proportions differed greatly. The overall scale effective rate was 9.31%, of which, station scale of higher than it was 55.56%. In the matter of ratio, proportions of stations held by enterprises, colleges, tertiary hospitals and individuals were obviously lower than others. The mean percentage of increasing returns to scale was 59.31%, when technology was effective and scale was invalid. There were no community health service stations which had increasing returns to scale, at the same time, scale was effective and technology was invalid. The proportion of invalid scale was about 82.99%, and significantly higher than technical inefficiency which was 64.93%. It could severely impact the overall effective rate. Conclusions: In service implementations, community health service stations held by medical institutions were slightly better than others. However, internal proportions differed greatly. In general, other types’ service effects had little differences. The stations transformed by primary and township hospitals used minimum inputs to get maximum outputs, which were suitable for primary care health services. The government should change community health service-input model and break limits of industry affiliation, to complete the transformation from ‘provide services’ to ‘buy services’. By comparing medical allocation efficiencies in stations established by medical organizations, it would give good warnings about medical treatment combinations’ mass establishments |
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