The efficiency of residency training and health outcomes in China: Based on two-stage DEA and cluster analysis

IF 6.2 2区经济学 Q1 ECONOMICS

Socio-economic Planning Sciences Pub Date : 2024-09-12 DOI:10.1016/j.seps.2024.102057

Guangwei Deng, Yongbin Pan, Chenpeng Feng, Liang Liang

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引用次数: 0

Abstract

To address the residency training performance and further explore its determinants, with the help of a unique dataset, our study calculated the efficiency of residency training and health outcomes in 18 Chinese tertiary hospitals from 2020 to 2021 using a two-stage data envelopment analysis (DEA) model given the two-stage characteristics of vocational training and clinical practice of residents. The results showed that the efficiency of the sample hospitals in both residency training and medical service provision was high, there are approximately 1/3 hospitals of sub-efficient in each stage, but the number of efficient units for assessing the residency training performance was slightly less than that for assessing the health outcome performance. All the decision-making units (DMUs) were clustered into four groups through K-means cluster analysis according to efficiency results. The results showed that there was an obvious inconsistency between the teaching goals and the health outcome goals of Chinese public hospitals. In some hospitals, the low residency pass rate resulted in the low efficiency in stage 1, while the redundant inputs in beds resulted in the low efficiency in stage 2. Residency training hospitals should strengthen their synergistic management in programs of residency training and health outcomes.

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中国住院医师培训的效率与健康结果：基于两阶段 DEA 和聚类分析

为了解决住院医师培训绩效问题并进一步探讨其决定因素，我们的研究借助独特的数据集，针对住院医师职业培训和临床实践两个阶段的特点，采用两阶段数据包络分析（DEA）模型计算了2020-2021年18家中国三级医院的住院医师培训效率和医疗效果。结果表明，样本医院在住院医师培训和医疗服务提供两个阶段的效率都较高，每个阶段都有约1/3的医院处于次效率状态，但评估住院医师培训绩效的有效单位数量略少于评估医疗成果绩效的有效单位数量。根据效率结果，通过 K-均值聚类分析将所有决策单元（DMU）分为四组。结果表明，中国公立医院的教学目标与健康结果目标之间存在明显的不一致性。部分医院住院医师培训合格率低导致第一阶段效率低，而床位冗余投入导致第二阶段效率低。住院医师培训医院应加强住院医师培训与健康结果项目的协同管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Socio-economic Planning Sciences OPERATIONS RESEARCH & MANAGEMENT SCIENCE-

CiteScore

9.40

自引率

13.10%

发文量

294

审稿时长

58 days

期刊介绍： Studies directed toward the more effective utilization of existing resources, e.g. mathematical programming models of health care delivery systems with relevance to more effective program design; systems analysis of fire outbreaks and its relevance to the location of fire stations; statistical analysis of the efficiency of a developing country economy or industry. Studies relating to the interaction of various segments of society and technology, e.g. the effects of government health policies on the utilization and design of hospital facilities; the relationship between housing density and the demands on public transportation or other service facilities: patterns and implications of urban development and air or water pollution. Studies devoted to the anticipations of and response to future needs for social, health and other human services, e.g. the relationship between industrial growth and the development of educational resources in affected areas; investigation of future demands for material and child health resources in a developing country; design of effective recycling in an urban setting.