Research On Operating Efficiency Of Chinese Hospital

In 2009,the Central Committee of the Communist Party of China and the State Council issued the "Opinions on Deepening the Reform of the Medical and Health System",which clearly stated that "by 2020,a more scientific management system and operating mechanism of medical and health institutions will be established in general to form a diversified medical system." Since then,new The medical reform has been implemented for ten years.At the same time,performance definition and evaluation is an important way to standardize the hospital’s external management system and internal operating mechanism.In the reform practice after the new medical reform,relevant government agencies have successively issued a series of hospital performance appraisal documents to ensure the realization of the reform goals.The overall medical and health service level in my country and the internal operating efficiency of hospitals have been improved to varying degrees.And improvement.Due to the new changes in the internal and external environment,the current system and mechanism reforms still have much room for optimization and improvement.To this end,this article selects relevant data from hospitals in 30 provinces and regions(except Tibet)after the new medical reform,and conducts efficiency calculations and influencing factors analysis through empirical research to illustrate the trend of changes in my country overall medical efficiency vertically and horizontally compare each The actual regional gap.Based on the efficiency evaluation,the empirical results of this article can also provide a basis for the improvement of the external system and internal mechanism of the hospital in the next step,and then provide reasonable suggestions that can be used as a reference for the common problems of "difficult and expensive medical treatment" in our society.Based on this practical significance,Chinese scholars have conducted many theoretical discussions and empirical analyses.This article has two main differences:First,the stochastic frontier model is the most commonly used method for measuring hospital efficiency,but the impact of endogeneity on the estimation and measurement results has not been considered in the past research results.The deviation of the empirical results is not conducive to the reform proposal.Precise guidance.This paper introduces the endogenous stochastic frontier model into hospital efficiency measurement for the first time,compares the differences in parameter estimation and efficiency measurement in the two situations of ignoring endogenity and eliminating endogenity,and makes relevant suggestions based on more accurate and realistic empirical results.Second,in terms of the efficiency estimation of medical and health institutions,most of the existing literature selects medical institutions in certain regions such as a certain city or a certain province for analysis,while this article uses all hospitals across the country as a sample to conduct an empirical analysis and in-depth evaluation of my countrys new medical reforms The results of hospital reform in my country are compared horizontally and vertically,and the efficiency changes and room for improvement of Chinese hospitals.This article first summarizes the development process of the endogenous stochastic frontier model and the current research status of domestic and foreign scholars on hospital efficiency measurement.Next,analyze the development history and existing problems of Chinese hospitals.Then it introduces the used model in detail,including likelihood estimation method,endogenity test and efficiency calculation method.Secondly,based on the actual situation in my country,270 panel data from 2010 to 2018 in 30 provinces and regions are selected to measure the technical efficiency level of Chinese hospitals under the two situations of ignoring endogeneity and eliminating endogeneity.The empirical results show that the parameter estimation results and efficiency calculation results of the stochastic frontier model after eliminating the endogenity are quite different from those when the problem is ignored,and the citation of the endogenous stochastic frontier model better fits the reality.In addition,the empirical results after eliminating the endogenous problem show that the average efficiency of hospitals during the sample period in my country’s provinces is 73.29%,which is at the middle and upper level;at the same time,the average efficiency of hospitals in my country during the sample period fluctuates slightly,tending to a steady increase;The difference in the average efficienc between provinces and regions is relatively obvious;different environmental variables and other factors have different mechanisms for poor hospital efficiency,which can be improved and perfected in a targeted manner.Based on the results of the empirical research in this article,we propose the following five suggestions:First,rationally allocate medical resources between different regions and narrow the gap between different regions.Due to the differences in factors such as the degree of economic development among my country’s provinces,the allocation of medical resources between the eastern region and the central and western regions continues to be polarized.The most effective way is to increase government fiscal transfer payments.At the same time,advocating counterpart assistance from developed regions to backward regions is a simpler method that can be used,including the export and exchange of high-level medical personnel,professional equipment,advanced diagnosis and treatment methods,etc.,which can alleviate the "difficulty in seeing a doctor" in the western region to a certain extent.The problem.Second,implement oriented reform measures for different types of hospitals to improve the efficiency of the entire industry.For public hospitals oriented to public welfare,a new type of charging scheme can be implemented on a trial basis-payment by disease or payment by population,to avoid excessive charging of unreasonable medical expenses by hospitals,further reduce the burden of medical funds for the people,and reduce the cost of medical treatment in the whole society "The negative impact of the problem.For the development of private hospitals,the barriers to entry can be further relaxed,encouraging the formation of a diversified and diversified social medical pattern,and facilitating its development from the design of the upper-level mechanism,thereby improving the overall medical efficiency of the society and forming a reasonable and orderly The medical situation of competition,diversified rapid development and continuous improvement of efficiency.Third,attach importance to the incentives for health technicians and reasonably define their work intensity and content.On the one hand,a complete performance appraisal plan can be established to scientifically define the salary standards of medical workers;on the other hand,the hospital personnel reform system can be deepened,and equal pay and treatment for equal posts can be implemented to maximize human resource initiative.Fourth,shorten the average length of stay for discharged patients and optimize the utilization rate of hospital beds.By supporting the application of medical insurance to private hospitals and encouraging the provision of integrated medical care services,accelerating the progress of the implementation of clinical pathways,and actively improving the implementation of the hierarchical diagnosis and treatment system,the current situation of insufficient bed resources and unreasonable allocation of hospital beds has been improved,and problems such as "difficult medical treatment" have been alleviated.Fifth,reform and improve the current fixed asset management system to improve its operational efficiency.Through all-round monitoring and tracking of its use process,standardizing procurement standards,and implementing a regulatory responsibility system,it will give play to its actual value and provide certain assistance to the improvement of my country’s overall medical service capabilities.