目的: 探明不同供给模式的定点照护服务机构运行效率及影响因素,为完善我国长期照护服务体系提供理论依据。方法: 使用青岛市调查数据,纳入定点照护服务机构32家。采取三阶段DEA方法测量不同供给模式的定点照护服务机构运行效率,并运用Tobit模型进行影响因素分析。结果: 32家定点照护服务机构运行效率平均值为0.647,其中,PPP供给模式机构、政府包办供给模式机构分别为0.651和0.628。供给模式、地理位置、长护险费用结算是否及时、是否医养融合均对定点照护服务机构运行效率产生显著正向影响（P<0.05）。结论: 定点照护服务机构尚处于起步阶段,PPP供给模式相较于政府包办供给模式效率值更高,应坚持长期照护服务PPP供给模式改革方向,用好政府宏观调控工具包,加大医养结合政策推动力度,进而提升定点照护服务机构运行效率。
Abstract
Objective: The paper analyzes the operation efficiency and influencing factors of designated care service institutions with different supply modes, so as to provide theoretical evidence for improving the long-term care service system. Methods: Using the survey data of Qingdao City, 32 designated care service institutions were included. The three-stage DEA method was used to measure the operation efficiency of designated care service institutions with different supply modes, and the influencing factors were analyzed by Tobit model. Results: The average value of operation efficiency of 32 designated care service institutions is 0.647, of which PPP supply mode institutions and government supply mode institutions are 0.651 and 0.628 respectively. Supply mode, geographical location, timely settlement of long-term care insurance costs and combination of medical care and nursing has a significant positive impact on the operation efficiency of designated care service institutions. Conclusion: The designated care service institutions are still in the initial stage, and the PPP supply mode is more efficient than the government supply mode. It is necessary to adhere to the reform direction of the PPP supply mode of long-term care services, make advantage of the government's macro-control toolkit, and strengthen the promotion of the combination of medical care and nursing policies to improve the operation efficiency of designated care service institutions.
关键词
长期照护服务 /
运行效率 /
定点照护服务机构 /
PPP /
影响因素
Key words
long-term care services /
operation efficiency /
designated care service institution /
PPP /
influencing factor
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 徐宏,岳乾月.新时代背景下长期照护服务PPP供给模式研究[J].山东社会科学,2018(8):90-96.
[2] 李志广,孔爱杰,张婉莹.基于三阶段DEA的我国医疗卫生机构运行效率的测度与评价[J].中国卫生统计,2021,38(2):257-261.
[3] 何庆南,常维夫.基于德尔菲法的三级定点医疗机构医保绩效评价指标体系构建研究[J].中国医疗保险,2023(4):25-30.
[4] 边妗伟.基于DEA-Malmquist模型的养老机构供给效率研究[J].中国卫生资源,2022,25(5):669-674.
[5] FRIED H O, LOVELL C A K, SCHMIDT S S, et al.Accounting for environmental effects and statistical noise in data envelopment analysis[J].Journal of productivity analysis,2002(17):157-174.
[6] 王安琪,尹文强,唐昌海,等.资源整合视角下山东省村卫生室服务效率评价研究[J].中国卫生统计,2023,40(1):78-81.
[7] 任洁.机构养老服务效率研究——以厦门市为例[J].人口与经济,2016(2):58-68.
[8] MIN A, PARK C G, SCOTT L D.Evaluating technical efficiency of nursing care using data envelopment analysis and multi-level modeling[J].Western journal of nursing research,2016,38(11):1489-1508.
[9] SEBASTIAN K, JAN S, ANDREAS F, et al.The use of data envelopment analysis (DEA) in healthcare with a focus on hospitals[J].Health care management science,2019,22(2):245-286.
[10] 原新,金牛,石航.医养结合机构效率评价与提升研究——基于天津调查数据的三阶段DEA模型分析[J].西北人口,2021,42(1):1-9.
[11] 卓丽军,路伟,李浩,等.二级公立医院实行托管模式前后效率比较研究——以广东省某市为例[J].中国卫生政策研究,2020,13(9):68-74.
[12] 李娟,吴炳义,马晨,等.不同类型养老机构资源配置效率的调查研究[J].中国全科医学,2016,19(17):2068-2071+2077.
[13] 王洪娜.医养结合养老机构服务效率及其影响因素——基于山东省226家医养结合养老机构数据分析[J].重庆社会科学,2020(5):129-140.
[14] 胡闰虎,王兆仑,贾常离,等.湖北省医疗救助效率评价研究——基于Bootstrap-DEA方法[J].中国医疗保险,2022(1):40-43.
[15] 朱宇航,郭继志,罗盛,等.简易应对方式问卷在老年人群体中的修订及信效度检验[J].中国卫生统计,2016,33(4):660-664.
[16] 雷咸胜.中国长期照护服务供给体系及其PPP取向[J].老龄科学研究,2017,5(7):12-21.
基金
国家社会科学基金面上项目“长期照护保险制度试点模式效果评估与路径优化研究”（19BGL199）; 教育部人文社会科学青年基金项目“多层次养老服务体系对非正式照料者的支持效果及提升策略研究”（22YJCZH103）; 山东省社会科学规划研究项目“基于时间银行的山东省代际互助养老服务体系构建及运行机制研究”（21CSHJ13）; 山东省社会科学普及应用研究项目“老年人积极老龄化理念培育研究”（2022-SKZC-28）
