目的:评估我国东部79个城市乡镇卫生院整体运行效率,优化资源配置。方法:运用数据包络分析各地区乡镇卫生院技术效率和规模效率并在不同省份之间进行比较。结果:乡镇卫生院不同种类资源配置比例相差较大;医生的日均门诊量9.4人次,年均提供364个住院床日服务;护士年均提供685个住院床日服务;79个城市乡镇卫生院整体效率平均值达到0.8154。技术效率达到0.8334,规模效率达到0.9794;医生和检验等其他技术人员配置过高是影响运行效率的重要因素;床位、医生、护士以及其他卫技人员分别可减少2.2%、14.1%、0.9%和14.6%。结论:各地应在控制乡镇卫生院整体规模的基础上。调整资源配置模式,利用结余人力大力开展公共卫生服务,重点提高医生的技术水平和服务能力。
Objective: To analyze the total medical resources of township hospitals in 79 cities in eastern China to improve the resource structure. Methods: Analyze the technical efficiency and scale efficiency by Data Envelopment Analysis (DEA) and compare the efficiencies in different provinces. Results: The ratios of medical resources are different in 79 cities. Every, doctor in township hospitals provides service for 9.4 outpatients everyday and 364 working days for inpatients annually. Every nurse provides 685 working days for inpatients annually. The overall efficiency of township hospitals from 31 cities is 0.8154, technical efficiency is 0.833 4, and scale efficiency is 0.979 4. The most important factor to impact on efficiency is distributing more doctors and other technical staffs. In 79 cities, the hospit~s beds, doctors, nurses, other technical staffs should be reduced by 2.2%, 14.1%, 0.9% and 14.6%. Conclusion: The medical resource allocation should be improved; the saved human resource can provide more public health services and improve the doctors' technical ability and service level based on controlling the total scale of township hospitals.