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目的评价与解析山东省县级公立医院新医改前后(2006—2012)的效率动态变化情况。方法采用DEA-Malmqusit指数模型,分析山东省两类共227所县级公立医院新医改前后全要素生产率及其分解项的变化情况。结果新医改前后,山东省县级公立医院中,82.38%(187/227)可以实现全要素生产率提高,但是主要通过技术进步来实现;59.91%(91/227)的医院技术效率未得到提高,其中综合医院有52.71%(68/129)的医院纯技术效率提高,但是规模效率低下,而县级公立中医院中48.98%(48/98)的医院纯技术效率与规模效率均呈下降趋势。结论大部分医院全要素生产率呈现增长趋势,但存在过度依赖技术进步的问题;综合医院需适度发展规模以提高规模效率,中医院则需侧重提高纯技术效率。
Objective To evaluate and analyze the dynamic changes of the efficiency of Shandong Provincial Public Hospital before and after the new medical reform (2006-2012). Methods The DEA-Malmqusit index model was used to analyze the changes of total factor productivity and its decomposed terms before and after the new medical reform in two types of public hospitals in Shandong Province. Results Before and after the new medical reform, 82.38% (187/227) of county-level public hospitals in Shandong Province could achieve the improvement of total factor productivity, but mainly achieved through technological progress. The technical efficiency of 59.91% (91/227) hospitals was not improved, Among them, 52.71% (68/129) of hospitals in general hospitals improved the pure technical efficiency, but the scale efficiency was low, while that of 48.98% (48/98) hospitals in county-level public hospitals decreased. Conclusion Most of the hospitals show a trend of increase in total factor productivity, but there is the problem of over-reliance on technological advancement. Comprehensive hospitals need to be modestly developed in order to increase the scale efficiency. TCM hospitals need to focus on improving purely technical efficiency.