Research On The Efficiency Of Resource Allocation Of Primary Medical And Health Institutions In A City

Background:Since the Reform and Opening-up,with the government's attention and continuous investment,medical and health undertakings have achieved remarkable results and achievements.But at the same time,we should also be aware that there are still some problems in the allocation of health resources in China,such as irrational structure,imbalance between supply and demand,and low overall efficiency,which is particularly prominent in the allocation of health resources in grass-roots medical and health institutions in China nowadays.With the promotion of graded diagnosis and treatment system,some residents returned from large hospitals to primary medical and health institutions.Under the limited allocation of health resources,whether grass-roots medical and health institutions can meet people's growing demand for health services has become an important issue to be studied.Objective and content:Research purposes:To evaluate the efficiency and influencing factors of grassroots allocation.Research content:First,through the on-the-spot investigation to understand the situation of resource allocation in primary health care institutions;second,use literature summarization and expert interviews to screen out the input and output indicators of the efficiency evaluation part of this study,and analyze The efficiency of resource allocation in primary health care institutions;thirdly,qualitative and quantitative analysis of resource allocation efficiency of grassroots medical and health institutions in the survey area,and explore possible ways to improve the efficiency of health resource allocation;Fourth,propose to further strengthen the service capacity of primary health care institutions.The recommendations provide a reference for improving the overall efficiency of primary health care institutions.Methods:Qualitative and quantitative analysis were used in this study.Qualitative analysis includes literature research and typical investigations.Through literature research,we can understand the research status,research methods and conclusions of the allocation efficiency and influencing factors of primary health care institutions at home and abroad,sort out the existing problems,and apply method of establishing input-output indicator pool of the data envelopment analysis based on this as well as standardizing service volume.Through the typical survey method,we can understand the configuration status,operational status,basic medical services and basic public health service provision status and existing problems of the basic medical and health services in the survey area in detail,and determine input-output indicators for data envelopment analysis,further standardize the relevant indicators as well.Quantitative analysis includes descriptive statistical analysis and data envelopment analysis.Descriptive statistical analysis describes the basic status of all 66 township hospitals in 3 districts and counties of a city,to find the problems,and determine the sampling method of data envelopment analysis based on this.Then 30 township hospitals were selected,and the allocation efficiency was analyzed by data envelopment method.Result:This paper mainly includes two parts:the current situation and operation problems of resource allocation of primary medical and health institutions in a city and the evaluation of resource allocation efficiency of primary medical and health institutions.(1)Current status and operational problems of the resource allocation of primary health care institutions in a city:Due to the influence of local social and economic levels,the resource allocation levels of township hospitals are different from a district to another.District A has better economic conditions and a larger population.The allocation of health resources is also better than that of the other two counties.The overall level of health resource allocation in the city has increased year by year.Correspondingly,the basic medical and health service capacity of District A is relatively high,which has certain attraction to other two counties.But work efficiency of the doctors in District A is not ideal compared to the average level in Anhui Province.The shortage of the number of health technicians in township hospitals and village clinic directly affects the ability to provide primary health care services,and it is an issue that needs to be addressed in the "Primary Diagnosis" of grading diagnosis and treatment.(2)Evaluation of resource allocation efficiency of grassroots medical and health institutions:Due to the advantages of policy environment,configuration level and service capacity,the overall efficiency of township hospitals in District A is higher than that of County C.The township hospitals in District A and County B have more scientific medical cooperation mechanism and advantages in basic public health service mechanism,fund allocation system as well as appropriate technology for Chinese medicine and equipment promotion,as a result their pure technical efficiency is higher than that of County C.The number of township hospitals with effective scale is small,and policy adj ustment can be adopted according to supply and demand to allow health resources flow from diminishing scale township health centers to increasing ones.The excess ratio of each input factor can explain the low level of utilization of different health resources in the actual work of the township hospitals in the three districts.In District A,the overall utilization level of each input factor is higher,and the excess ratio is lower.The allocation level of fixed assets in County B is low,which also leads to the corresponding insufficient output and waste.The problem of the lack of development of bed resources and technicians in County C has directly affected the improvement of health service capacity and caused a large amount of waste of corresponding resources.Conclusion:The level of resource allocation and utilization of primary medical and health institutions needs to be improved.The rural primary health care service market in the city has a large demand,low resources and low utilization,and the relationship between the three is not balanced.We should first improve the service capacity of various types of health resources,especially human resources,at the grassroots level,increase the utilization of health resources,and then allocate resource increments as appropriate according to supply and demand,in order to reverse the imbalance of grassroots health needs,health resources and health services.The shortage of human resources is an urgent problem to be solved in the allocation of resources for primary health care institutions.The supply and demand of grassroots health workers cannot be adjusted by market mechanisms totally.The wages of personnel cannot reflect the real market supply and demand information.Market failures are more obvious,so government regulation should be played as sufficient leading role.The output of basic medical and health services should satisfy the residents'needs preferences to the greatest extent.The areas with strong basic medical service capacity should closely integrate basic medical services with basic public health services and chronic disease management with family doctors' contracting services,to improve basic medical services and gradually assume the function of "primary diagnosis at the grassroots level" in the grading diagnosis and treatment.In areas with weak basic medical service capabilities,the general medical level of grassroots health human resources should be improved,and family doctor services should be developed with the prevention and control of chronic diseases,to improve the ability of basic medical services,in order to match basic public health services to provide strong support to the latter,thus achieving the goal of "strong grassroots".It is urgent to promote and improve the grading diagnosis and treatment system in rural areas,and to promote the "family doctor" contracting service is the key point and breakthrough point to alleviate the above problems and achieve graded diagnosis and treatment.To improve the basic medical service ability,attract residents to sign service agreements with family doctors voluntarily.Re-direct the basic medical service needs back to the primary health care institutions,promote the rational allocation of health resources between medical institutions at all levels,thereby improving the allocation efficiency of primary health care institutions and alleviating the problem of "expensive medical treatment and difficult medical treatment".