一个网络-DEA模型来评估质量和访问对医院绩效的影响
G P Afonso1, D C Ferreira1, J R Figueira2
1CERIS, Instituto Superior Técnico, Universidade de Lisboa, Avenida Rovisco Pais, 1, 1049-001 Lisbon, Portugal.
Annals of operations research
|June 26, 2023
概括
这项研究使用网络数据包围分析 (NDEA) 探索了医疗保健的权衡. 调查结果表明,医院效率与质量/接入维度之间存在潜在的冲突.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 运营研究 运营研究
- 卫生经济学 卫生经济学
背景情况:
- 医疗保健效率,质量和获取之间的关系仍然定义不佳,在潜在的权衡方面没有共识.
- 现有的研究缺乏一个全面的框架,可以同时评估这些关键的医疗保健方面.
研究的目的:
- 引入和应用一种新的网络数据包围分析 (NDEA) 模型,以评估医院效率,质量和接入之间的权衡.
- 提供关于国家医疗保健系统中这些权衡存在和性质的经验证据.
主要方法:
- 网络数据包围分析 (NDEA) 模型与输出可用性较弱相结合,以解决不良输出 (质量差,无法访问).
- 来自葡萄牙国家卫生服务 (2016-2019) 的数据使用四种模型的19个变量进行了分析,以量化效率,质量和获取.
- 构建了假设场景,以评估质量和访问维度对效率得分的影响.
主要成果:
- 该研究发现了医院效率,护理质量和服务获取之间的有意义的潜在权衡.
- 大多数分析的变量都对医院整体效率产生了显著的负面影响,这表明质量或接入的改善可能会降低效率.
- 新的NDEA方法提供了对这些复杂的相互关系的更现实的评估.
结论:
- 在实现高医院效率与确保高质量的护理和公平获取之间存在明显的权衡.
- 医疗保健政策决策必须仔细考虑这些权衡,以优化资源分配和服务提供.
- 使用先进的分析方法进行进一步的研究是有必要的,以完善我们对医疗保健系统性能的理解.
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