天津市公立医院效率动态评价——基于DEA-Malmquist指数模型

目的 分析新医改以来天津市公立医院效率动态变化情况，进而为管理者改进管理、制定发展战略和医改政策提供参考。方法 采用因子分析方法对原始指标数据进行降维处理，采用DEA-Malmquist指数分析法对2008-2019年期间天津市72家公立医院效率动态变化情况进行分析。结果 2008-2019年期间，样本医院全要素生产率（TFP=1.005）缓慢提升，且有波动性；效率提升主要来自技术进步（TC=1.006）；规模效率（SEC=0.999）不高导致技术效率（TEC=0.999）下降，已成为制约效率提升的主要阻力；同时，各地区纯技术效率和规模效率发展不均衡，且仍有提升空间。结论 技术进步促进效率提升效果显著，资源冗余、控制规模与引导内涵式发展有待加强；针对区域差异因地制宜，有的放矢，促进全市医院效率全面协同均衡发展。

Dynamic evaluation on the efficiency of public hospitals in Tianjin——based on DEA-Malmquist index model

To analyze the dynamic changes on the efficiency of public hospitals in Tianjin City since the newmedical reform，and to provide a reference for managers to improve management and formulate development strategies andmedical reform policies.Methods Factor analysis method was used to reduce the dimension of the original index data，andDEA－Malmquist index analysis method was used to analyze the dynamic changes of the efficiency of 72 public hospitals inTianjin City during 2008 to 2019.Ｒesults During 2008 to 2019，the total factor productivity(TFP=1.005)of samplehospitals increased slowly and there was fluctuation.Efficiency improvement mainly came from technological progress(TC=1.006);The low scale efficiency(SEC=0.999)led to the decrease of technical efficiency(EC=0.999)，which had becomethe main resistance to restrict the improvement of efficiency.At the same time，the development of pure technical efficiency(PTEC)and SECwas not balanced，and there was still room for improvement.Conclusion The effect of technologicalprogress in promoting efficiency is remarkable and resources are redundant.The control of scale and guidance of connotativedevelopment need to be strengthened.Aiming at regional differences，measures should be taken according to local conditionswith some targets to promote the comprehensive，coordinated and balanced development of hospital efficiency in city.