数据包络分析法在综合性医院科室效率评价中的应用

目的：以某大型综合性三甲医院17个临床科室作为研究对象,对其相对效率进行评价,为医院管理者进行科学决策提供一种可操作性的思路。方法运用专家咨询法确定投入产出指标,投入指标包括：医护人均数、床位数、设备投入,产出指标包括：门诊量、出院人次、业务总收入,运用数据包络分析法（ data envelopment analysis, DEA）进行相对效率评价和分析。结果得出各临床科室的综合效率、纯技术效率、规模效率、规模收益情况,以及非有效科室的产出不足比例。17个临床科室的平均综合效率值是0.849,总体有效的科室共有5个,总体无效的科室共有12个。这12个科室没有同时达到技术有效和规模有效,说明其还存在投入过剩或产出不足的问题,或是现有规模偏大或是偏小等问题。17个临床科室的平均技术效率值是0.945,技术有效的科室共有11个,技术无效的科室共有6个。这6个科室需要改善运营管理,通过改进病床管理手段提高床位的周转效率,对设备进行结构或功能的优化调整,提高医生的诊疗水平和服务态度等手段,以达到最大产出。结论 DEA方法应用于医院临床科室的效率评价,既能对各科室进行效率高低的比较,又能较为准确的指出产出不足的地方,能够为医院科学化决策提供依据。

Application of DEA in evaluation on the efficiency of clinical departments

Objective To take 17 clinical departments of a large first-class hospital as the object of study, and to carry out the assessment on its relative efficiency in order to propose a practical idea of scientific decision-making for the hospital administrators. Methods Expert consultation method was applied to determine the input-output index. The input indexes included average medical stuff number, bed number and equipment input. The out indexes included outpatient mount, inpatient mount and total income. Data Envelopment Analysis （ DEA） was used to carry out relative efficiency assessment and analysis. Results The comprehensive efficiency, pure technical efficiency, scale efficiency and returns to scale of each clinical department were worked out, so was the output deficiency ratio of non-effective decision-making units. The average comprehensive efficiency of 17 clinical departments was 0. 849, 5 of them were of total efficiency, and 12 were of total inefficiency. The fact these 12 department did not achieve both technical efficiency and scale efficiency at the same time illustrated there were some factors such as over input or output shortage or the large or small of the current scale etc. The average technical efficiency of 17 clinical departments was 0. 945, 11 of them were of technical efficiency, 6 were of technical inefficiency. For achieving the maximum output, these 6 departments need to improve the operation management by improving the management of beds to increase the bed turnover rate, adjusting equipment to optimize the structure or function and enhancing the doctor’s diagnosis and treatment level and service attitude. Conclusion Applying DEA method on the efficiency assessment of hospital clinical departments can not only compare the efficiency of each department, but also point out where output deficiency exists, to provide a basis for the scientific decision-making of the hospital.