The Analysis Of The County-level Hospitals’Operation Efficiency In Shandong Province Under The Background Of Health Care Reform

County-level hospitals are the important part of our nation’s medical and health service system, what’s more, they are the leader of county-level health care center and the rural level3health service network, and they cooperate with the city hospitals. The function orientation is to provide the basic medical and health service for the residents of the country, and solve the problem of "difficult and expensive medical care" effectively. On the other hand, county-level public hospital reform is an important link for the achievement of new health care reform goal. Analyzing the resources allocation and benefits of county-level hospitals can help to improve the efficiency and quality of hospital service under this background. As a result, the assessment of county-level hospitals’operation efficiency is of great significance.ObjectivesWe analyze the status of the input, output and efficiency of county-level hospitals in Shandong Province by the data envelopment analysis method:CCR model, BBC model and Malmquist exponential model. Then we provide the scientific advice for the rational allocation and the hospital development.MethodsThis research data comes from the2010-2012statistics report of health statistics center, mainly about the data of manpower, financial resources and health service output. Based on the organic combination of CCR, BBC and Malmquist exponential model, we make the transverse annual analysis and longitudinal inter-temporal analysis comparatively. ResultsThe comprehensive efficiency of105county-level hospitals in Shandong Province is not ideal from2010to2012.There are26comprehensively effective hospitals in2010, accounting for24.76%;21comprehensively effective hospitals in2011, accounting for20%;27comprehensively effective hospitals in2011, accounting for25.71%.The ratio of pure technical efficiency from2010to2012is37.14%,31.43%and35.24%respectively. In scale efficiency change, there are30hospitals whose scale reward is changeless in2010, accounting for28.57%,26hospitals whose scale reward is decreasing, accounting for28.57%,49hospitals whose scale reward is increasing, accounting for46.67%.In2011, there are24hospitals whose scale reward is changeless, accounting for22.86%,26hospitals whose scale reward is decreasing, accounting for24.76%,55hospitals whose scale reward is increasing, accounting for52.83%.In2012, there are31hospitals whose scale reward is changeless, accounting for29.52%,36hospitals whose scale reward is decreasing, accounting for34.29%,38hospitals whose scale reward is increasing, accounting for36.19%.The total factor productivity annual average of105county-level hospitals in Shandong Province increases by3.1%; technological change index annual average increases by5.1%; comprehensive efficiency annual average decreases by1.9%; pure technical efficiency annual average decreases by1.4%; scale efficiency annual average decreases by0.5%. The improvement of total factor productivity benefits from technological progress, while the decline of comprehensive efficiency is due to the decline of pure technical efficiency and scale efficiency.Conclusions and suggestionsBy the analysis of the105county-level hospitals’ operation efficiency in Shandong Province from2010to2012, we find that the total factor productivity of county-level hospitals is in a rising state, however the comprehensive efficiency is in a state of decline, what’s more, the proportion of comprehensively effective hospitals is small. It shows that under the existing investment scale, the output part of county-level hospitals doesn’t reach optimization and resources waste phenomenon exists. As a consequence, county-level hospitals can solve the problem from the following three aspects:At first, achieve the rational allocation of medical resources in the county, improve the utilization efficiency; second, strengthen the construction of talent team, improve the efficiency and quality of medical service. At last, play the support role of level3general hospitals and perfect technology and management concept.