Analysis of factors influencing efficiency of 53 medical consortia in Shanghai based on DEA-Tobit model
ZONG Lian1, WANG Xian-mei2, HE Fan1, MENG Yang1, JIN Chun-lin3, ZHANG Xiao-xi3
1. Baoshan District Center for Disease Control and Prevention, Shanghai 201901, China; 2. Nanjing Audit University, Nanjing, Jiangsu 211899, China; 3. Chinese Center for Tropical Diseases Research, Shanghai Jiaotong University School of Medicine/Shanghai Jiaotong University-Universityof Edinburgh Center for Global Health Research, Shanghai 200030, China
Abstract：Objective To take 53 medical consortia in Shanghai as the research subjects, to analyze the factors affecting efficiency of the medical consortia based on input-output index and efficiency evaluation results, and to provide a theoretical and practical basis for realizing construction goal of the medical consortia and optimizing allocation of health resources. Methods The efficiency value served as the explained variable, the influencing factors as the explanatory variables, and Stata as statistical software. An analysis was performed by random-effect panel Tobit regression model. Results A model with 4 influencing factors was screened out by stepwise regression. The F value of the model was 20.70, P was less than 0.001, and the original hypothesis of significance test of the regression equation was rejected. Among them, secondary hospital-proportion of personnel with vice senior and above professional titles was positively correlated with efficiency of the medical consortia, and the partial correlation coefficient was 1.060 (P=0.014). Tertiary hospital-discharged patients'average length of stay in hospital, secondary hospital-discharged patients' average length of stay in hospital, and secondary hospital-average cost of outpatient and emergency treatment per time were negatively correlated with efficiency of the medical consortia, and the partial correlation coefficients were -0.036 (P<0.001), -0.014 (P<0.001) and -0.001 (P=0.007), respectively, all showing statistically significant differences. Conclusion Standardizing the two-way referral process can shorten the average length of stay in hospital so as to improve efficiency of the medical consortia. Implementing relevant medical insurance systems within the medical consortia can reduce the average cost of outpatient and emergency treatment per time so as to improve operation efficiency of the medical consortia. Creating conditions to encourage the optimization of grass-roots talents and increasing secondary hospital-proportion of personnel with vice senior and above professional titles are conducive to improving internal operation efficiency of the medical consortia.
宗莲, 王贤梅, 何凡, 孟杨, 金春林, 张晓溪. 基于DEA-Tobit模型的上海市53家医联体效率影响因素分析[J]. 实用预防医学, 2022, 29(7): 822-826.
ZONG Lian, WANG Xian-mei, HE Fan, MENG Yang, JIN Chun-lin, ZHANG Xiao-xi. Analysis of factors influencing efficiency of 53 medical consortia in Shanghai based on DEA-Tobit model. , 2022, 29(7): 822-826.
2022, Vol. 29 
