| Objective:Taking county-level traditional Chinese medicine hospitals across the country as the research object,and taking 2015-2019 as the timeline,this study conducts a dynamic analysis of the operational efficiency of county-level traditional Chinese medicine hospitals across the country from five dimensions:different regions,levels,categories,poverty alleviation counties,and central investment.It explores the differences,progress,and correlation with existing policies in terms of operational efficiency,and proposes feasible suggestions to improve operational efficiency based on local conditions,Furthermore,we will improve the quality of medical services,strengthen the functions of traditional Chinese medicine services in counties,and expand the supply of traditional Chinese medicine services in rural healthcare systems.Methods:Firstly,literature analysis method is used to sort out Chinese and English literature as well as traditional Chinese medicine policy documents,and relevant research results are summarized;Secondly,cluster analysis and correlation analysis are used to determine the DEA evaluation index model,and descriptive statistical analysis is conducted on the input-output situation of the sample hospitals,in order to systematically and comprehensively understand the resource input-output status of the sample hospitals;The third is to use the DEA Malmquist index method to conduct dynamic research on the operational efficiency of county-level traditional Chinese medicine hospitals,and determine the main reasons for the changes in operational efficiency of county-level traditional Chinese medicine hospitals based on the changes in the comprehensive efficiency change index and the technological progress change index.Results:(1)Overall,the total factor productivity change index from 2015 to 2019 was 1.006,with an average annual increase of 0.6%in operational efficiency.However,the average comprehensive efficiency was 0.557,indicating an overall poor operational efficiency;From different years,the operational efficiency of county-level traditional Chinese medicine hospitals in China shows a fluctuating upward trend.(2)From different regional perspectives,the total factor productivity change indices of countyle vel traditional Chinese medicine hospitals in the eastern,central,and western regions from 2015 to 2019 were 1.018,1.011,and 1.005,respectively.The operating efficiency increased by 1.8%,1.1%,and 0.5%,showing a difference of eastern>central>western regions,which is consistent with the regional status of China’s economic development.(3)From the perspective of different levels and categories,from 2015 to 2019,the operational efficiency of county-level Chinese medicine hospitals at the first level,unclassified,second level,and third level increased by 0.71%,0.99%,and 3.68%,respectively,with the most significant improvement in the operational efficiency of third level hospitals;Among different types of hospitals,county-level traditional Chinese medicine specialty hospitals have the most significant improvement in operational efficiency,with an overall increase of 2.8%.The advantages of traditional Chinese medicine specialty hospitals are prominent,and anal and intestinal hospitals have a more obvious development advantage in traditional Chinese medicine specialty hospitals.(4)From the perspective of poverty-stricken counties,the average change index of total factor productivity of traditional Chinese medicine hospitals in povertystricken counties is 1.013,and its operating efficiency has increased by 1.28%overall compared to the previous period,higher than the national average level.Among them,57.09%of traditional Chinese medicine hospitals in poverty alleviation counties have improved their operational efficiency.(5)From the perspective of central investment,from 2015 to 2019,under the situation of central investment,the average change index of total factor productivity was 1.000,and the operational efficiency of hospitals remained stable,but lower than the national average and did not show a significant upward trend;During the period from 2015 to 2019,the operational efficiency of county-level traditional Chinese medicine hospitals showed a fluctuating upward trend,which is consistent with the changes in the operational efficiency of county-level traditional Chinese medicine hospitals nationwide;Among them,50%of county-level traditional Chinese medicine hospitals have improved their operational efficiency.Suggestions:(1)The economic foundation determines the superstructure.The construction,development and efficiency improvement of county-level TCM hospitals should first of all continue to increase government support,actively implement the responsibility of government investment,establish a multi-level investment mechanism,constantly increase the investment and support for grass-roots medical and health undertakings,and strengthen the role of the implementation of the medical security system as a guarantee;For poverty-stricken and extremely impoverished areas,key support should be given,combined with rural revitalization policies to strengthen support,increase the supply of high-quality traditional Chinese medicine medical services,drive the improvement of hospital operating efficiency with high-quality services,and strengthen the supply of traditional Chinese medicine medical services at the county level.(2)From the perspective of building the service capacity of county-level traditional Chinese medicine hospitals,with highlighting the unique advantages of traditional Chinese medicine as the core,strengthening the construction of advantageous traditional Chinese medicine specialties,continuously improving the service capacity of traditional Chinese medicine specialty hospitals and comprehensive hospitals,and expanding new features on this basis;At the same time,we will effectively combine modern science and technology with traditional Chinese medicine diagnosis and treatment equipment,enrich traditional Chinese medicine clinical therapies,effectively improve the clinical efficacy of traditional Chinese medicine,and promote the improvement of the operational efficiency of county-level traditional Chinese medicine hospitals by leveraging the unique advantages of traditional Chinese medicine.(3)From the perspective of the allocation of traditional Chinese medicine medical and health resources,the uneven allocation of traditional Chinese medicine medical and health resources reminds the government and hospital management departments to adapt to local conditions,scientifically plan according to the functional positioning of hospitals,form a joint force at both macro and micro levels,promote the rational layout of medical and health resources in the eastern,central,western,and central regions,narrow regional disparities through medical consortia,and strive to improve the service capacity of traditional Chinese medicine at the grassroots level,In order to realize that everyone has access to high-quality TCM services and lay the foundation for medical services to achieve the goal of"common prosperity".(4)From the perspective of enhancing the connotation of county-level traditional Chinese medicine hospitals,the improvement of operational efficiency of county-level traditional Chinese medicine hospitals should not only be a one-sided expansion of scale and purchase of equipment,but also focus on the reform and innovation of management systems.Always put people at the center of the system,adhere to the characteristics of traditional Chinese medicine as the principle,strengthen comprehensive budget management,quality supervision and management,and reward and punishment mechanisms,standardize medical behavior in a sound management system,and ensure the quality of medical services;At the technical level,it is necessary to carry out "Internet plus" medical treatment and telemedicine with informatization as the support and TCM talents as the driving force to improve the accessibility of TCM services;At the same time,the idea of smart hospital construction is introduced into the hospital construction to integrate the information flow of the hospital.Continuously improving the system and technology to achieve connotation management,ultimately promoting the improvement of operational efficiency of county-level traditional Chinese medicine hospitals. |
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