| Objective:Women and children are the largest number of social groups,and their health level affects the overall health of the country,which is a public health problem that can not be ignored.This study will comprehensively analyze the underlying health resource circumstance,health expenses of women and child health care hospitals in Hainan Province,and the relevant health level indicators of women and children.Further analysis of integrated technical efficiency,cost efficiency,and factors influencing women and child health care hospitals and propose relevanted counterplans and advices from the angles of efficiency level of women and child health care hospitals and government investment.Methods:Based on the basic data of women and child health care hospitals in Hainan Province,Excel was used to establish a database,and Spss 22 was used for descriptive analysis and comparison.On the basis of the document Investigations and the feasibility and scientificity of indices,the technical efficiency,pure technical efficiency and scale efficiency of women and child health care hospitals in Hainan Province were analyzed by using Deap 2.1 software and data envelopment(DEA)BCC model.Using Frontier 4.1 software,the cost efficiency of women and child health care hospitals in Hainan Province is analyzed by using stochastic frontier(SFA)transcendental logarithmic cost efficiency model.Using Stata 15.1 software and Tobit regression model,the internal influencing factors related to women and child health care hospitals were analyzed.Results:1.The maternal mortality indicator in Hainan Province from 2015 to 2019 was increased from 10.16/100,000 to 11.57/100,000,the infant mortality index was reduced from 6.03‰ to 4.15‰,and the under-5 mortality rate indicator was reduced from 8.02‰ to 6.19‰.During the same period,the premarital medical examination rate in Hainan Province decreased from 49.22% to 26.69%.2.From the aspect of human resources for health in women and child health care hospitals in Hainan Province,number of active employees is increasing,from 2,867 in 2015 to 3738 in 2019,but the rise rate has eased and the staffing shortage has grown large.The provincial women and child health care hospitals have the best allocation of human resources for health,while the lower-level grassroots women and child health care hospitals have a large gap in health technicians.3.From the health and material resources of women and child health care hospitals in Hainan Province,the total value of equipment above 10,000 yuan increased from 295.37 million yuan in 2015 to 1,051.88 million yuan in 2019,and the number of equipment above 10,000 yuan increased from 1,951 units in 2015 to4,550 units in 2019.Fixed assets expanded from 278.49 million yuan to 390.19 million yuan,of which 2019 provincial women and child health hospitals Total fixed assets accounted for the highest proportion of the province’s women and child health care hospitals of 46%.4.In terms of bed usage in women and child health care hospitals in Hainan Province,the effective number of beds expanded from 1,333 in 2015 to 1,912 in2019,of which 631 were in provincial women and child health care hospitals in 2019(accounting for 33% of the total number of beds in the province),796 were in prefecture(city)level and 796 were in county(district)level In 2019,the Bed occupancy ratio of in prefecture(city)level women and child health care hospitals was the topmost at 86%,followed by provincial women and child health care hospitals at 69%,and county-level women and child health care hospitals at 48%.5.From 2015 to 2019,the total health cost of hospitals in Hainan Province increased from 25.011 billion yuan to 42.114 billion yuan,and the health cost of public health hospitals increased from 2.518 billion yuan to 3.493 billion yuan,among which the health expenses of women and child health care hospitals increased from 1.016 billion yuan to 1.916 billion yuan.6.The results of DEA-BCC model analysis of women and child health care hospitals in Hainan Province,the technical efficiency of only 6 women and child health care hospitals is 1,while that of other 18 women and child health care hospitals is less than 1.Analysis on the affecting factors of technical efficiency.The index of women and child health care hospitals’ operation status,solvency and cost management ability are significantly positive,while the indicators of medical expenses control ability are significantly negative.Analysis of the affecting factors of pure technical efficiency;The indicators of operational status and cost management ability of women and child health care hospitals are significantly positive,while the indicators of medical expenses control ability are significantly negative.For the scale efficiency,the indicators of women and child health care hospitals are significantly positive,while the indicators of hospital income structure are significantly negative.7.The average cost efficiency of women and child health care hospitals in Hainan Province decreased from 0.9168 in 2015 to 0.8431 in 2019.Analysis of the influencing factors of cost efficiency The indicators of the operation status,cost management ability and medical expense control ability of women and child health care hospitals are significantly positive.Conclusions:1.Among the three main indicators related to the level of maternal and child health in Hainan Province,except that the maternal mortality index has fluctuated and increased,the other two indicators have decreased year by year,and except that the maternal mortality index rose higher than the national average in 2017,they are all lower than the national average,indicating that the health level of women and children in Hainan Province is good,but there is a gap between Hainan Province and the more economically developed areas in the country.However,among the related indicators of maternal and child health care services in the province,the rate of premarital examination is low,which should be paid more attention to.2.There is a big gap in the establishment of medical and health technical personnel,and there is an imbalance in material and human resources.High-quality medical and health resources are mainly distributed in women and child health care hospitals with higher budget levels.The medical and health resources of primary women and child health care hospitals are relatively weak,the use of hospital beds is low,and the utilization of resources is insufficient.3.The proportion of health expenses of women and child health care hospitals in Hainan Province is relatively small,and the medical and health expenses flowing to women and child health care hospitals are increasing year by year,but the growth rate is slow.4.There are 6 comprehensive and technically effective women and child health care hospitals,and the other 18 women and child health care hospitals have not reached the frontier efficiency level,which is due to the ineffectiveness of pure technical efficiency and the loss of scale efficiency.The reforming of operational conditions,solvency and cost management ability of medical hospitals is conducive to the improvement of technical efficiency of women and child health care hospitals,but the low control of medical expenses is not beneficial to the overall effectiveness of hospitals.The growth in medical revenues is not beneficial to the improvement of scale efficiency,and the good operation of women and child health care hospitals can promote scale efficiency.5.The cost efficiency of all women and child health care hospitals in Hainan Province shows a decreasing trend.The promotion of operational status,cost management ability and medical expense control ability of women and child health care hospitals on cost efficiency. |
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