民营医院发展对中国公立医院运营效率的作用机制研究——基于Malmquist-Tobit工具的实证分析

目的:分析民营医院发展对公立医院运营效率的作用机制及大小。方法:利用Malmquist-Tobit工具实证分析民营医院发展对公立医院运营效率的影响。结果:2010—2015年中国公立医院全要素生产率指数均值为1.036,技术进步和技术效率贡献率分别为66.7%、33.3%。全要素生产率与技术进步、技术效率相关系数为0.328、0.742。民营医院结构优化对公立医院运营效率具有显著抑制效应,民营医院核心资源为显著促进效应,民营医院机构数量和产业规模作用不显著。结论:中国公立医院运行效率整体处于改善阶段,不规则负增长与区域、省际分化并存。技术进步和技术效率双路径驱动运营效率提升。民营医院发展对公立医院运营效率作用机制表现为民营与公立医院结构性竞争框架下蕴含的异质性、非对称性和门限特征。

The effect of private hospitals development on the operational efficiency of public hospitals in China: An empirical analysis based on the Malmquist-Tobit method

Objective: To analyze the effect of private hospitals development on the operational efficiency of public hospitals. Methods: The effect was performed using the Malmquist-Tobit Method. Results: The results found that from 2010 to 2015, the average factor of Total Productivity Index (TPI) of the Chinese public hospitals was 1.036 and the contribution rates of technological progress and technical efficiency were 66.7% and 33.3%, respectively. The coefficients of correlation between total productivity index, technological progress and technical efficiency were 0.328, 0.742. The structure optimization of private hospitals exerted a very significant inhibitory effect on the operating efficiency of public hospitals. The core resources of private hospitals were significantly promoted, and the number of public hospitals and scale of industries were not significant as per results revealed. Conclusion: The operational efficiency of the public hospitals in China was in the overall improvement stage, but there was a threat of irregular negative growth associated with regional and inter-provincial differentiation. The operational efficiency was driven by the technical progress and efficiency double paths. The effect of private hospitals on operational efficiency of public hospitals was characterized by heterogeneity, asymmetry and threshold characteristics under the framework of structural competition between private and public hospitals.