Analysis And Evaluation On Technical Efficiency Of Medical And Health Institutions In China Based On Dynamic Network DEA

Objective: In this study,the technical efficiency of medical and health institutions as the research object,we analyse medical and health institutions' input-output situation in nearly five years,calculate technical efficiency to discuss factors leading to low efficiency,optimize the structure of input and output,reduce waste,to improve the technical efficiency of medical and health institutions and provide scientific advice and suggestion.The specific objectives include:(1)To summarize several DEA models commonly used in the field of health in recent years,the evolution process and the theory is discussed in detail;(2)To study of the index system in common use;(3)To know the status of resource allocation and medical service of medical and health institutions in China in recent 10 years;(4)To explore the current situation of the technical efficiency of medical and health institutions in 31 provinces and cities,and to analyze the slack variables of the invalid provinces,so as to provide specific suggestions for improving the technical efficiency;(5)To analyze the factors affecting the technical efficiency of medical institutions.Content: This study selected the health statistical data during 2006-2015,selecting the number of medical institutions,human resources,health facilities,and the number of hospital visits to describe the status of medical and health institutions' resource allocation and medical service in China.Secondly,it described the evolution process of DEA model and the related theories,which lays the foundation for the following research.Finally,this study analyzed and evaluated technical efficiency of medical and health institutions of 31 provinces using Dynamic Network DEA model,including the overall technical efficiency,subsystem technical efficiency and slack variable.Tobit regression model was used to analyze the influencing factors of technical efficiency of medical and health institutions.At the same time,according to the above research results and discussion,combined with the actual situation of our country,to provide policy recommendations to improve the technical efficiency of medical and health institutions.Method:(1)Descriptive analysis: this study used time series data and cross-sectional data to analyze the resource allocation and medical service of medical and health institutions,in order to compare the differences in different years and different regions.(2)Delphi method: in the first round,experts need to evaluate each indicator in the "input and output indicators," and "the degree of matching with the system";in the second round and the third round,experts need to evaluate the importance of each indicator in the system.(3)Boundary value method: according to the matching degree,the full frequency,mean and variation coefficient were calculated,and the indexes which didn't meet the 3 criteria were excluded.(4)Dynamic DEA Network model: according to the theory of health production,we choose the variable scale and non-oriented Dynamic Network DEA model to calculate the technical efficiency of medical and health institutions.(5)Tobit regression model: the overall efficiency as dependent variable,the factors affecting the efficiency as independent variable to analyse various factors,and the degree of influence was estimated by the estimated coefficient.Result: In 2011-2015,the input of human resources,material resources and financial resources of medical and health institutions in China increased in varying degrees,but output growth was limited.In the five years,the average efficiency score of medical and health institutions was 0.808,a total of 8 provinces to achieve overall effectiveness,individual provinces had large differences in efficiency values.The overall average efficiency score of management dimension was 0.911,which was slightly higher than the overall average efficiency value of medical dimension.But in some areas,the overall inefficiency of medical institutions was due to the low efficiency of management dimension.To make all provinces in the production frontier,medical and health institutions need to reduce investment or increase output.In addition,the results of the study showed that the number of medical institutions,health workers per thousand population,the number of doctors' daily visits,emergency mortality,mortality in observation room,bed utilization rate and the average hospitalization days on the technical efficiency of medical and health institutions have influence.Conclusion: Government investment in health care institutions increase,but the output growth is limited.There is a certain degree of waste.There is great differences in the technical efficiency of medical institutions,and the distribution of medical and health resources is uneven.The management level of medical institutions is limited,and the quality of medical service needs to be improved.According to the results and conclusions,this study proposes the following recommendations:(1)To establish efficiency concept,and configure reasonably health resources.(2)To optimize combination mode of input elements,and improve scientific compensation mechanism.(3)To promote the construction of grading system and the redistribution of excess health resources(4)To update the management concept and improve the competitiveness of medical institutions.(5)Innovating the mode of medical service supply and improving the quality of medical service.(6)To strengthen the health service of the key population,improving the national health insurance system.(7)Make full use of Internet plus mobile treatment to improve the technical efficiency.(8)To optimize the diversified medical pattern and develop new forms of health services.