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本文应用卫生服务提供的生产函数原理,对华东四省8家县级中医院作十年投入产出动态分析。结果揭示了临床医生是当前中医院服务提供数量的唯一决定要素,虽然它们只有县医院1/3的规模,但结果表明县中医院已呈饱和状态,每增10%的临床医生只能为增加服务提供量8%。其他投入要素,如病床,固定资产(包括仪器设备)和其他非临床人员(包括卫技、行政管理和后勤)对卫生服务提供贡献很小。表明县中医院投入要素未能发挥协同替代作用,难以实现人、财、物的优化组合。指出调整县级中医院经济规模,优化结构是其未来生存发展的一个极需解决的课题。
This paper applies the principle of the production function provided by the health service, and makes a dynamic analysis of the input and output of the eight county-level hospitals in four provinces in East China. The results reveal that clinicians are the only decisive factor in the number of hospital services currently available. Although they are only one-third the size of county hospitals, the results indicate that the county hospital has become saturated, and every 10% of clinicians can only increase. The amount of service provided is 8%. Other inputs, such as beds, fixed assets (including equipment) and other non-clinical personnel (including health care, administration, and logistics) contribute little to health services. It shows that the input factors of the county hospital fail to play a synergistic role and it is difficult to achieve the optimal combination of people, finances, and goods. It is pointed out that the adjustment of the economic scale of county-level hospitals and the optimization of their structure is an issue that needs to be resolved in the future.