Application of mathematical models on efficiency evaluation and intervention of medical institutions in China.

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Qiwen Tai, Qinghua Wang, Jiang Li, Nannan Dou, Huazhang Wu
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Abstract

BACKGROUND : The efficiency of medical services directly impacts the economic burden of healthcare, making it crucial to analyze the input-output efficiency of various types of medical institutions. However, while hospitals had been extensively analyzed for their efficiency, other types of medical institutions had received limited attention in this regard. METHODS : In this study, we employed data envelopment analysis (DEA) methods based on time series and internal benchmarks to autonomously assess the efficiency of 18 distinct categories of healthcare facilities in China over the past decade. The verification was conducted through the utilization of the critical incident technique (CIT). Additionally, we utilized the Delphi process (AHP) method to evaluate suppliers of medical consumables, implemented a multi-population genetic algorithm for managing these consumethod and analytic hierarchymables efficiently, and applied stakeholder theory to manage medical personnel efficiency.  RESULTS : Our findings indicated that medical institutions capable of providing clinical services exhibited higher levels of efficiency compared to those unable to do so. Multiple indicators suggested redundancy within these institutions. Notably, comprehensive benefit evaluation revealed that clinical laboratory had performed poorly over the past decade. We selected an inefficient medical institution for intervention in reagent management and the work efficiency of medical staff. After implementing the Delphi method and multi-population genetic algorithm for consumable replenishment, the reagent cost was reduced by 40%, 39% and 31% respectively in each of the three experimental groups, compared to the control group. By applying stakeholder theory and process reengineering methods, we were able to shorten quality control management time for medical staff in the experimental group by 41 min per day, reduce clinical service time by 25 min per day, and extend rest time by 70 min per day, while the quality indicators were all meeting the targets. CONCLUSION: By employing various mathematical models as described above, we were able to reduce costs associated with medical consumables and enhance medical personnel work efficiency without compromising quality objectives.

数学模型在中国医疗机构效率评估和干预中的应用。
背景:医疗服务的效率直接影响医疗保健的经济负担,因此分析各类医疗机构的投入产出效率至关重要。然而,虽然对医院的效率进行了广泛分析,但其他类型医疗机构在这方面受到的关注却很有限。方法在本研究中,我们采用了基于时间序列和内部基准的数据包络分析(DEA)方法,自主评估了过去十年中国 18 个不同类别医疗机构的效率。验证是通过关键事件技术(CIT)进行的。此外,我们还利用德尔菲过程(AHP)方法对医用耗材供应商进行了评估,实施了多人口遗传算法来有效管理这些耗材和分析分层,并应用利益相关者理论来管理医务人员的效率。 结果 :我们的研究结果表明,与无法提供临床服务的医疗机构相比,有能力提供临床服务的医疗机构表现出更高的效率。多项指标表明,这些机构内部存在冗余。值得注意的是,综合效益评估显示,临床实验室在过去十年中表现不佳。我们选择了一家效率低下的医疗机构,对试剂管理和医务人员的工作效率进行干预。在采用德尔菲法和多人口遗传算法进行耗材补充后,与对照组相比,三个实验组的试剂成本分别降低了 40%、39% 和 31%。通过运用利益相关者理论和流程再造方法,实验组医务人员的质控管理时间每天缩短了 41 分钟,临床服务时间每天缩短了 25 分钟,休息时间每天延长了 70 分钟,各项质量指标均达标。结论:通过采用上述各种数学模型,我们能够在不影响质量目标的前提下,降低与医用耗材相关的成本,提高医务人员的工作效率。
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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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