目的:评价基本药物实施前后,乡镇卫生院生产率变化情况。方法:通过分层随机抽样和现场调查收集30家样本乡镇卫生院的投入和产出数据,利用Deap 2.1测算乡镇卫生院2007—2012年的Malmquist全要素生产率指数变化情况。结果:30家乡镇卫生院从2006—2012年职工总数呈逐年递增趋势,但在2009年职工总数比2008年有所下降;年占用总床日数呈逐年增加趋势,从2008年开始年增长率呈逐年降低趋势,2010年到达阶段性最低点;每职工平均负担年占用床日数呈逐年上升趋势,但年增长率呈逐年下降趋势,在2010年降低到阶段性最低点;年检验总次数逐年增加,2008年增长率达到阶段性最大值;2009年以后年增长率变化趋于平缓。2008年以后30家乡镇卫生院的年生产率指数平均值均小于1,提示乡镇卫生院的生产力呈逐年衰退趋势;标准差呈逐年减小,提示乡镇卫生院的生产力有逐年趋同趋势。经秩和检验,发现每两年之间差异无统计学意义。结论:基本药物制度实施前后,乡镇卫生院生产率呈逐年降低趋势,但总体变化不显著。
Objective:To evaluate productivity change of the township hospitals before and after the implementation of the essential medicine system.Methods:The data about inputs and outputs of 30 sample township hospitals were collected through stratified random sampling and field investigation. The Malmquist productivities of township hospitals from 2007 to 2012 were measured through Deap2.1.Results:The number of staffs in 30 township hospitals increased by year from 2006 to 2012,but which of 2009 was less than that in 2008. The total occupied bed days increased year by year,but there was a decrease started from 2008,and the lowest point appeared in 2010. The labor intensity and the average bed days per worker increased by year,but the average increase rate decreased and the lowest point appeared in 2010. The number of tests increased,and the highest point appeared in 2010. The average increase rate became gentle after 2009. After 2008,the average productivity index was less than 1,which was an inclination of productivity. Through the Rank-Sum Test,there was no significant statistical difference.Conclusion:There was an inclination of the productivity without significant changes before and after the implementation of the essential medicine system.