Research On Economic Efficiency And Influencing Factors Of Public Hospitals In Nanchang

ObjectiveUnder the policy background of further deepening the reform of the medical and health system and establishing a modern hospital management system,the BCC model was used to measure the economic efficiency of 41 public hospitals in Nanchang from 2009 to 2017.On this basis,a Tobit regression model with technical inefficiency,pure technical inefficiency,and scale inefficiency as dependent variables is constructed to explore the influencing factors of Nanchang public economic efficiency,so as to provide policy recommendations for the healthy and sustainable development of Nanchang public hospitals.MethodsThis study took 41 public hospitals in Nanchang from 2009 to 2017 as the research objects.The data comes from the Jiangxi Province Total Health Expenditure Function Method Accounting Research Group and the 2009-2020 "Jiangxi Province Statistics Yearbook".(1)DEA’s BCC model.The BCC model of data envelopment analysis is used to analyze the economic efficiency of 41 public hospitals in Nanchang,including four aspects: technical efficiency,pure technical efficiency,scale efficiency and return to scale status.(2)Tobit regression model.Regression analysis of influencing factors is carried out based on technical inefficiency,pure technical inefficiency,and scale inefficiency as the dependent variable.The software used is DEAP2.1,IBM SPSS Statistics 25,stata16.Results(1)Research results of the BCC modelIn terms of time,the average technical efficiency of 41 public hospitals in Nanchang from 2009 to 2107 was 0.815,and the average annual technical efficiency was 13 public hospitals,accounting for 27.6% of the total sample;the average pure technical efficiency was 0.885,pure technology There are an average of 21 efficient public hospitals per year,accounting for 51.21% of the total sample;the average scale efficiency is 0.918,and the average annual efficiency of large-scale public hospitals is16,accounting for 39.02% of the total sample.From the perspective of hospitals with different functions,the technical efficiency of general hospitals(0.838)>specialty hospitals(0.794)>Chinese medicine hospitals(0.796),and the pure technical efficiency of general hospitals(0.902)>specialty hospitals(0.857)>Chinese medicine hospitals(0.879)),the scale efficiency shows general hospitals(0.923)>Chinese medicine hospitals(0.921)>specialty hospitals(0.908).From the perspective of redundant input and insufficient output,from 2009 to 2107,17 Nanchang public hospitals never achieved a technical efficiency score of 1,and a total of 9 companies that never achieved a pure technical efficiency score of 1,and scale efficiency scores never reached There are 13 companies in 1 in total.(2)Research results of the Tobit modelFrom the perspective of technical inefficiency,the medical care ratio,the number of bed turnovers,the average medical expenses per visit,and the average number of visits per doctor per day have a significant positive impact on the technical inefficiency,but the average hospital stay and the proportion of medicines have a significant negative Among them,the regression coefficient of the proportion of medicine is the largest,and its return coefficient is 0.208,indicating that the proportion of medicine has the greatest impact on the technical efficiency of the sample public hospitals;From the perspective of pure technical inefficiency,the number of bed turnovers,the average medical expenses per visit,the average number of visits per doctor per day,and the average number of hospital bed days per physician have a negative impact on the pure technical inefficiency,but the average hospital stay returns The coefficient is positive and has a significant positive effect;From the perspective of scale inefficiency,the ratio of medical care,the number of bed turnovers,the average medical expenses per visit,and the average number of visits per doctor per day have a negative impact on the scale inefficiency of the sample public hospitals.However,the proportion of medicines has no effect on the scale of the sample public hospitals.Efficiency has a positive effect,and its regression coefficient is the largest,indicating that this variable has the greatest impact on scale efficiency.Conclusion(1)The economic efficiency of public hospitals in Nanchang City is not high,and there is a significant gap in the economic efficiency of hospitals with different functions.(2)Most internal factors have a negative impact on the economic inefficiency of public hospitals in Nanchang,but the average hospital stay and the proportion of drugs have a positive impact on the economic inefficiency.Sugestion(1)Optimize the scale of public hospitals,enhance the hospital’s technological innovation capabilities,and improve economic efficiency.(2)Treat public hospitals with different functions differently,and pay attention to the scientificity and coordination of the allocation and use of health resources.(3)Strengthen the optimized management of the internal environment and improve the management level.