Использование непараметрического анализа данных для оценки эффективности муниципальных медицинских учреждений региона

Abstract

The effectiveness of medical institutions is usually assessed by indicators characterizing the economic, medical and social aspects of their activities. Indicators of medical effectiveness (ME) reflect the achievement of certain medical results with the optimal use of available resources, both for a particular patient, and for a medical institution and the regional healthcare system as a whole. The ME estimates are relevant and in demand both by internal consumers – the management of institutions and the healthcare system, and by external consumers who finance it. To assess the ME of medical municipal institutions, it is proposed to use the Data Envelopment Analysis (DEA) of data characterizing the results of their functioning and recorded by the current system of medical statistics. This method does not require the identification of functional relationships between the results of the activities of medical institutions and the resources they consume. Aim. Determination using the method of shell analysis of data on the medical effectiveness of municipal medical institutions of the Khanty-Mansiysk Autonomous Okrug – Ugra based on standard statistical data on the results of their activities. Materials and methods. The classical input-oriented model with a constant scale of return of the Data Envelopment Analysis (DEA) method was used to evaluate the medical effectiveness. The input indicators of this model characterize the main types of resources used by the medical institution. The indicators of the total number of temporary disability sheets issued to the residents of the municipality, the completeness of coverage by mandatory medical examinations of the population of the municipality and the load indicators of hospitals and outpatient departments of the medical institution were taken as days off. To ensure comparability, input and output indicators were recalculated per 1000 inhabitants of the municipality. The evaluation of the medical efficiency of municipal medical institutions was carried out in the MaxDEA 8 Basic environment. Results. Estimated indicators of medical efficiency of municipal medical institutions of the Khanty-Mansiysk Autonomous Okrug – Ugra for the period from 2013 to 2020 are given. The estimates obtained show that more than 60% of medical institutions functioned with maximum efficiency throughout the entire period. For insufficiently efficient institutions, target values of input indicators have been determined, the achievement of which will ensure the maximum values of the effectiveness of their activities. Conclusion. Among the municipal medical institutions of the district, the functioning of which during the entire observed period of time was characterized by maximum medical efficiency, the “leaders/landmarks” institutions were recommended. The indicators of the latter can be considered by the management of the health care system of the district as indicators in the development and implementation of management decisions to support and develop both this system and the institutions within it.