基于 Global-Malmquist 指数的山东省二级公立综合医院 2014 至 2023 年运行效率分析

Operational efficiency analysis of secondary public general hospitals in Shandong Province from 2014 to 2023 based on Global-Malmquist index

摘要

目的 分析山东省二级公立综合医院运行效率的变化情况，对比山东省省会、胶东、鲁南经济圈不同区域医院的效率差异，为二级公立综合医院差异化发展提供政策参考。方法 收集山东省省会、胶东、鲁南经济圈及 16 个地级市(莱芜市 2019 年并入济南市)二级公立综合医院 2014-2023 年的面板数据，确定投入与产出指标，使用基于超效率 SBM 模型的Global-Malmquist 指数模型分析效率变化。结果 2014-2023 年山东省二级公立综合医院的效率由 0.948 上升至1.320，省会、胶东与鲁南经济圈 2014-2017 年效率差异较小，2018-2023 年效率差异明显，全部 16 个地级市(除莱芜市外)中，15 个地级市的运行效率呈上升趋势，占比为 93.75%。结论 山东省二级公立综合医院的效率呈上升趋势，但波动变化较大，效率受技术变化因素的影响更明显，存在区域技术效率发展不平衡、应对重大公共卫生事件能力不足的问题，需实行技术与制度革新、规模调整等差异化的发展策略，推动医院实现高质量发展。

Abstract

Objective To analyze the changes in operational efficiency of secondary public general hospitals in Shandong Province, compare the efficiency differences among hospitals in different regions (the Provincial Capital Economic Circle, the Jiaodong Economic Circle, and the Lunan Economic Circle) of Shandong, and provide policy references for the differentiated development of secondary public general hospitals. Methods Panel data of secondary public general hospitals from 16 prefecture-level cities (Laiwu City was merged into Jinan City in 2019) and the three economic circles (the Provincial Capital Economic Circle, the Jiaodong Economic Circle, and the Lunan Economic Circle) in Shandong Province from 2014 to 2023 were collected. Input and output indicators were identified, and the Global-Malmquist index model based on the super-efficiency SBM model was used to analyze efficiency changes. Results From 2014 to 2023, the operational efficiency of secondary public general hospitals in Shandong Province increased from 0.948 to 1.320. The efficiency differences among the provincial capital, Jiaodong, and Lunan economic circles were small from 2014 to 2017 but became significant from 2018 to 2023. Among the 16 prefecture-level cities (excluding Laiwu), 15 showed an upward trend in operational efficiency, accounting for 93.75% of the total. Conclusion The operational efficiency of secondary public general hospitals in Shandong Province shows an upward trend but with large fluctuations. Efficiency is more significantly affected by technological changes. There are problems such as unbalanced development of regional technical efficiency and insufficient capacity in responding to major public health events. It is necessary to implement differentiated development strategies such as technological and institutional innovation and scale adjustment to promote the high-quality development of hospitals.

关键词

二级公立综合医院 / 运行效率 / Malmquist 指数模型 / 全要素生产率 / 区域差异 / 山东省

Key words

Secondary public general hospitals / Operational efficiency / Malmquist index model / Total factor productivity / Regional differences / Shandong Province

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基金资助

山东省社会科学规划研究项目(23CGLJ39)

国家卫生健康委医院管理研究所项目(NIHA24YYDQ13)

国家卫生健康委医院管理研究所项目(NIHA25YYDQ30)