贵州医科大学学报

目的 综合评价和分析2022年贵州省三级公立医院运营效率，为改善运营管理提供论证依据。方法 收集贵州省54所三级公立医院2022年绩效考核中“运营效率”结果，采用熵权优劣解距离(TOPSIS)法与秩和比(RSR)法及两者模糊联合对贵州省三级公立医院的运营效率进行综合评价。结果 共纳入三级公立医院运营效率评价指标15个；熵权TOPSIS评价结果显示，权重排名前三的指标分别是医疗服务收入占医疗收入比例(14.68%),万元收入能耗(11.21%)、住院次均费用增幅(10.93%),C_i值在0.441～0.625之间；RSR法分档结果显示运营效率排在A(优秀)、B(良好)、C(中等)及D(合格)的医院分别有4所(7.41%)、23所(42.59%)、24所(44.44%)及3所(5.56%)。结论 贵州省三级公立医院的运营效率整体偏向“中等”水平，各医院的运营效率差异主要体现在收支结构与费用控制；建议重点关注收支结构的调整和优化、加强成本精细化管理及合理控制医疗费用增幅，以提升医院运营效率。

Objective To evaluate the operational efficiency of tertiary public hospitals in Guizhou, and provide reference for improving hospital operation efficiency and management. Methods Fifty-Four tertiary public hospitals were selected as the research subjects based on the operational efficiency evaluation index in the performance assessment operation manual for tertiary public hospitals(2022). The entropy technique for order preference by similarity to ideal solution(TOPSIS) and rank sum ratio(RSR) methods were combined by fuzzy association to comprehensively evaluate the operational efficiency of 54 hospitals. Results The evaluation indicators for the operational efficiency of tertiary public hospitals include a total of 15 items. The entropy-weighted TOPSIS analysis revealed that the top three weighted indicators included "medical service revenue as a percentage of total healthcare income"(14.68%), "energy consumption per 10 000 Yuan of revenue"(11.21%), and "average hospitalization cost growth rate"(10.93%), with C_i values ranging from 0.441 to 0.625. The RSR method indicated that 4 hospitals were ranked A(highly efficient), 23 hospitals were ranked B(relatively efficient), 24 hospitals were ranked C(adequately efficient), and 3 hospitals were ranked D(developing efficiency). Conclusion The operating efficiency of tertiary public hospitals In Guizhou is generally adequately efficient. The differences in operational efficiency of hospitals is mainly reflected in the structure of income and expense control. The improvement of hospital operation efficiency should focus on the adjustment and optimization of income-expenditure structure, strengthen the fine management of cost, and reasonably control the increase of medical expenses.