Исследования динамики медицинской эффективности функционирования лечебно-профилактических учреждений региона с использованием индекса Малмквиста

Abstract

The paper provides assessments of the dynamics of the medical efficiency of the functioning of medical institutions in the Khanty-Mansiysk Autonomous Okrug in the period from 2013 to 2021 using the Malmquist index. Purpose of the study. The purpose of the study is to analyze the dynamics of the values of medical efficiency of the functioning of medical institutions of the Khanty-Mansiysk Autonomous Okrug - Ugra, united on an administrative-territorial basis, using the Malmquist index together with shell data analysis. Materials and methods. Direct assessments of the medical effectiveness of these institutions were carried out using shell data analysis. The set of input and output data of the analyzed institutions characterized the effectiveness of the provision of medical services in inpatient and outpatient settings of the institutions. The multiplicative decomposition of the Malmquist index made it possible to analyze the nature and level of influence on its values of such factors as technological changes in the subject area, the efficiency of the management of medical institutions and changes in their scale, i.e. volumes of medical services provi¬ded. Results. Based on the results of the study, it was established that changes in the values of the technological component of the decomposition of the Malmquist index have the greatest influence on changes in the medical efficiency of the functioning of medical institutions. The decomposition component, which characterizes the efficiency of the management of these institutions, is practically neutral. This indicates that the management of regional medical institutions has accumulated quite a large and successful management experience. The influence of the scale component depends on fluctuations in both the volume of medical services provided and the number of medical personnel in institutions. This was especially evident during the pandemic, characterized by strict quarantine restrictions. Conclusion. The use of the Malmquist index and the component of its multiplicative decomposition allows external and internal stakeholders to not only assess the medical effectiveness of the functioning of medical institutions, which is important from he point of view of their use of allocated funding, but also to identify the bearers of “best practices” in terms of the development and implementation of technologies provision of medical services, management of a medical institution and adaptation to changing internal and external conditions of its functioning.