| [Purpose]Based on the analysis of the current situation of the allocation of pediatric medical resources in Wuhan,the evaluation model and improvement strategy of the allocation efficiency of medical resources in pediatric departments of public general hospitals in Wuhan were discussed.[Methods]Wuhan is taked as the research area in this work.The current situation of allocation of pediatric medical resource,domestic and foreign efficiency evaluation methods and research progress is used by literature analysis to analyze.26 public general hospitals above level II in Wuhan from 2016 to 2018 is taked as the research object,and the basic information of sample hospitals,the current situation of pediatric operation and the data of pediatric medical resource allocation through field investigation is collected,combined with relevant public Open data,SPSS24.0 is used for descriptive analysis of Wuhan paediatric medical resource allocation status,basic situation of sample hospitals and changes from 2016 to 2018;typical hospital analysis and content analysis methods is used to in-depth analysis of symposia and interviews with 42 key informants;literature analysis method,expert consultation method and Pearson correlation analysis method were used to screen the efficiency evaluation indicators,on this basis,data envelope analysis method(Data-Envelopment-Analysis,CCR-BCC-Super Efficiency-Malmquist Model in DEA)constructs static efficiency and dynamic efficiency evaluation model of Pediatrics in sample hospitals and relevant ranking,evaluates and analyzes the operation efficiency of Pediatrics in sample hospitals from 2016 to 2018,and compares the efficiency from two dimensions;based on the analysis of current situation,content analysis of key informant interviews,efficiency evaluation and calculation results,integrative medicine is used.Therapeutic theory,put forward targeted and comprehensive improvement strategies.[Results]1.Analysis results of current allocation of pediatric medical resources in WuhanBetween 2016 and 2018,there was an increase in the number of pediatric medical staff in Wuhan,but there was little change in the proportion of pediatric medical staff in Wuhan,with the proportion ranging from 3% to 6%;the total number of beds in pediatric hospitals has increased,the proportion inreeased from 4.26% to 5.01%;The output of paediatric health service is increasing;pediatric medical resources are concentrated in the center of city.2.Distribution and Changes of Pediatric Medical Resources in Sample HospitalsAmong the sample hospitals,pediatrics is a smaller department,and the allocation of pediatric medical resources and the output of health services account for a small proportion.From 2016 to 2018,Pediatrics has an expanding trend in scale,especially the quickest growth rate of bed allocation,however,the input of human resources and equipment over RMB 10,000 has not changed much,and the superior resources are concentrated in the sample hospitals in the tertiary and urban centers.The output of health services is increasing year by year,and the technical ability of pediatric science and technology has been improved.3.Construction of efficiency evaluation index systemThrough the literature selection method at home and abroad,eight indicators of this study were preliminarily formed.After two rounds of expert consultation and Pearson correlation analysis of the preliminary indicators,the number of pediatric practicing(assistant)physicians,pediatric nurses and actual open beds were finally determined as input indicators,and the number of outpatient and emergency patients and the proportion of discharged patients in the total bed days as output indicators.4.Relative Efficiency of Pediatrics in Wuhan Sample HospitalFrom the results of dynamic relative efficiency evaluation,the comprehensive efficiency of 2016-2018 is 0.67,0.70 and 0.68,respectively,and under the combined effect of pure technical efficiency and scale efficiency,the overall relative efficiency is low.Among them,the average comprehensive efficiency of the three-level sample hospitals was 0.68,and that of the second-level sample hospitals was 0.70;that of the central sample hospitals was 0.62,and that of the suburban sample hospitals was 0.79.The scale remuneration is mainly decreasing.Projection analysis shows that input redundancy coexists with inadequate output,limited pediatric medical resources are not rationally utilized or the total output of health services is not optimal.From the perspective of dynamic efficiency,in the two dynamic phases of 2016-2017 and 2017-2018,the total factor productivity of Pediatrics in sample hospitals increased by 2%.The growth of total factor productivity of sample hospitals in 2016-2017 was due to the improvement of technical efficiency;the growth of efficiency change from 2017 to 2018 is the main reason for the growth of total factor productivity.[Conclusions]1.The total allocation of pediatric medical resources in the sample area shows an increasing trend,but the proportion of Pediatrics in the whole medical system is small;the superior pediatric medical resources are concentrated in the city center and tertiary medical institutions,which increases the competition and waste of pediatric medical resources in the city center.,and reduces the accessibility of pediatric medical resources services in the suburbs.2.From 2016 to 2018,the input of pediatric medical resources and the output of health services in sample hospitals were improved.,the departments have maintained a stable development trend,and the technical strength has also been improved,but the proportion of Pediatrics in the sample hospitals as a whole is small and the emphasis is not high.3.The comprehensive efficiency,scale efficiency and pure technical efficiency of Pediatrics in sample hospitals from 2016 to 2018 have not reached the relative effective state,and the growth rate of input is greater than that of output.The allocation efficiency of scarce pediatric medical resources needs to be further optimized.The comprehensive efficiency of tertiary and urban sample hospitals with more pediatric medical resources is lower than that of secondary and suburban sample hospitals.The average of all-factor productivity increased from 2016 to 2018,indicating that the utilization efficiency of pediatric medical resources has been improved in these three years.4.Improving strategies: strengthening the functions of the government and health administration departments on the micro level;strengthening the importance of medical institutions to pediatrics on the middle level;strengthening the internal management and technical level of pediatrics departments on the micro level. |
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