Community Hospitals Operational Efficiency Entropy Weight Method Weighted TOPSIS Method
江苏省科教能力提升工程（ZDXYS202210）；江苏省卫生健康委卫生健康经济管理研究课题（CW202224）；江苏省卫生健康委医学科研项目（H2023071）
目的：评价江苏省社区医院运营效率，探索影响因素，提出优化建议，为加强社区医院建设提供依据。方法：以江苏省210家社区医院为研究对象，采用熵权法与加权TOPSIS法对社区医院运营效率进行综合评价，采用定性分析法探索影响因素。结果：与2020年相比，2021年99家社区医院的运营效率相对有所改善，106家社区医院相对有所下降，5家社区医院排名没有变化。医疗服务收入（不含药品、耗材、检查检验收入）占医疗收入的比例是影响评价结果的最主要因素，主要影响因素包括专业人才招引难、医保基金向基层倾斜力度不够、基层医疗服务价格偏低等。结论：2019年-2021年，江苏省社区医院运营效率总体上相对有所改善，但受疫情影响较明显。建议加大专科人才培养力度，创新服务模式，提高医保基金用于基层机构的比例，健全医疗服务价格动态调整机制。
Objective：The study aims to evaluate the operational efficiency of community hospitals in Jiangsu Province，explore influencing factors，and provide optimization suggestions to support the enhancement of community hospital construction. Methods：The study focuses on 210 community hospitals in Jiangsu Province，using the entropy weight method and weighted TOPSIS method for a comprehensive evaluation of their operational efficiency. Qualitative analysis was employed to explore the influencing factors. Results：Compared to 2020，the operational efficiency of 99 community hospitals improved relatively in 2021，while 106 hospitals experienced a relative decline，and 5 hospitals saw no change in ranking. The proportion of medical service income（excluding drug，consumable，and diagnostic income）in total medical income was identified as is the most important factor affecting evaluation results. Major factors included difficulty of attracting professionals，insufficient tilting of health insurance fund to primary institutions and low prices of primary medical services. Conclusion：From 2019 to 2021，the overall operational efficiency of community hospitals in Jiangsu Province showed relative improvement，but was obviously affected by the epidemic. It is recommended to increase the training of specialized talents，innovate service modes，increase the proportion of medical insurance fund for primary institutions and improve the dynamic adjustment mechanism of medical service prices.