补偿机制转化与公立医院产出效率驱动1.docVIP

PAGE PAGE 6补偿机制转化与公立医院产出效率驱动王中华1 李湘君2（1.南京医科大学卫生政策研究中心 南京 210029）（2.南京中医药大学经贸管理学院 南京 210046）摘要：本文运用三阶段DEA及非参数核密度估计方法分析了补偿路径对公立医院产出效率的影响以及公立医院补偿机制转化的产出效率驱动路径。研究显示：药品和医疗服务费用路径对公立医院产出效率具有显著影响，财政补助的影响不显著；级别越高的公立医院其产出效率对补偿机制调整的敏感度越低；在未取消药品加成的情况下，单纯提高医疗服务收费等手段不但难于改变以药补医的格局，还会降低医院产出效率；二级公立医院由于结余量较小，政策调整的敏感度高，是公立医院补偿机制改革的最佳突破口；取消药品加成后，灵活调整补助额度，改变政府财政补助的概率分布特征，发挥财政补助对公立医院产出效率的显著正作用。关键词：补偿机制转化；公立医院；三阶段DEA；核密度估计Compensation Mechanism Reform and Public Hospital Wang Zhonghua1 Li Xiangjun2Health Policy Research Center of NanjingSchool of Trade and Management of Nanjing University of Abstract: Using three-stage DEA and nonparametric kernel density distribution, this paper analyzes the effect of compensation path on output efficiency of public hospital and the driving route of output efficiency for public hospital compensation mechanism transformation. The conclusions are as follows: medicine and medical service cost path has a significant impact on the public hospital output efficiency, financial subsidy effect is not significant; the higher the level of the public hospital, the lower the sensitivity for compensation mechanism adjustment to the public hospital output efficiency.; Before the abolition of drug addition, the medical service charge’s enhancing not only hard to change the situation, but also reduce hospital output efficiency; Due to small quantity balance and high sensitivity for policy to adjust ,two grade public hospitals are the best breakthrough for public hospital compensation mechanism reform; flexible adjustment of subsidy amount and the probability distribution characteristic of the government subsidy to play the positive role of subsidy on hospital efficiency.Key Words: Compensation mechanism; Public hospital; Three-stage DEA; Kernel density distribution作者简介：王中华，男，（1978-），河北行唐县人，南京医科大学卫生政策研究中心、公共事业管理系副教授，经济学博士，研究方向：卫生经济与管理。李湘君，女，（1977-），吉林省吉林市人，南京中医药大学经贸管理学院副教授，研究方向：卫生政策与卫生管理。联系方式：手机王中华) 。通讯地址：南京市汉中路140号南京医科大学公共事业管理系 邮编：210029 EMAIL:wz