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目的:分析基本药物实施前后乡镇卫生院效率变化情况。方法:利用分层随机抽样和现场调查法,收集2006年到2012年山东某市8县(市)30家乡镇卫生院的运行数据;使用Excel 2010建立数据库,利用Deap 2.1实施效率分析,并利用Stata11进行秩和检验。结果:30家乡镇卫生院开放床位总数、年检验总次数、年总收入和年总支出呈逐年上升趋势。但从2009年开始,增长速度明显放缓,年增长率呈逐年下降趋势。从增长率来看,年总支出和年总收入的增长率明显高于年开放床位数和年放射检查总次数增长率。从乡镇卫生院综合效率得分来看,2006年到2012年综合效率标准差呈逐年下降趋势,DEA有效的乡镇卫生院数量逐年减少。30家乡镇卫生院2010、2011年分别与2012年综合效率得分进行秩和检验,结果显示差异有统计学意义。即2012年综合效率得分较2010年和2011年有所下降。结论:乡镇卫生院实施基本药物制度以后,DEA有效的乡镇卫生院个数呈下降趋势,标准差呈减小趋势,说明在基本药物制度实施以后,乡镇卫生院服务能力和服务效率有趋同现象。
Objective: To analyze the changes of efficiency of township hospitals before and after the implementation of essential medicines. Methods: Using stratified random sampling and field survey, the data of 30 township hospitals in 8 counties (cities) of a city in Shandong from 2006 to 2012 were collected. Using Excel 2010, a database was constructed and the efficiency analysis was carried out using Deap 2.1. Stata11 rank sum test. Results: The total number of beds opened in 30 township hospitals, the total number of annual tests, the total annual income and total annual expenditure showed an upward trend year by year. However, from 2009 onwards, the growth rate slowed down significantly, and the annual growth rate showed a downward trend year by year. In terms of growth rate, the annual growth rate of total expenditure and total annual revenue was significantly higher than the annual number of open beds and annual radiological examination of the total number of growth rates. From the comprehensive efficiency of township hospitals point of view, from 2006 to 2012, the standard deviation of comprehensive efficiency showed a downward trend year by year, DEA effective number of township hospitals decreased year by year. 30 township hospitals in 2010 and 2011, respectively, with the 2012 comprehensive efficiency scores for rank sum test, the results showed that the difference was statistically significant. That is, the overall efficiency score for 2012 declined from 2010 and 2011. Conclusion: After the implementation of the basic medicine system in township hospitals, the effective number of township hospitals in DEA has been declining, and the standard deviation shows a decreasing trend. This shows that after the implementation of the basic medicine system, the service capabilities and service efficiency of township hospitals are similar.