Efficiency of Psychiatric Hospital under Ministry of Public Health

The objective of this study was to measure the hospital efficiency of psychiatric hospitals under the Department of Mental Health in Thailand in terms of technical and scale efficiency scores and to identify the factors determining the efficiency of hospitals. The data were from sixteen psychiatric hospitals under the Department of Mental Health since 2007 to 2010. The input variables were number of all staff (STAFF) and number of beds (BED) and the output variables were number of out-patient visits (OPD), number of in-patient bed days (IPD), and number of psychiatric nurse trainee (TRAIN). The results of DEA showed that TEVRS or pure technical efficiency score was 84%average (minimum 42%) and scale efficiency score was 85% (minimum 46%). Decreasing returns to scale is the majority cause of scale inefficiency. The regression analysis results showed OPD/STAFF, IPD/BED, average length of stay and psychiatric nurse trainee activity had significant positive relationship with TEVRS. The results suggested for downscaling and re-allocation of inputs. Promotion and support the development of proactive outpatient services were recommended. Last, we should focus more on capacity building of nurse training program in more hospital.本研究旨在测算泰国精神卫生部下辖精神专科医院的技术效率与规模效率得分，并识别影响医院运营效率的核心因素。本研究数据源自2007至2010年间泰国精神卫生部下属的16家精神专科医院。本次研究选取的输入变量为全体员工总数（STAFF）与床位数（BED），输出变量则包括门诊就诊人次（OPD）、住院床日数（IPD）以及精神科护士培训人数（TRAIN）。数据包络分析（Data Envelopment Analysis, DEA）结果显示，纯技术效率（pure technical efficiency，简称TEVRS）平均得分为84%（最低为42%），规模效率平均得分为85%（最低为46%）；规模报酬递减是引发规模无效率的最主要原因。回归分析结果表明，门诊人次/员工数（OPD/STAFF）、住院床日数/床位数（IPD/BED）、平均住院时长以及精神科护士培训活动与纯技术效率均存在显著正向相关关系。研究结果建议对医院投入要素进行缩减与重新配置，并应推动并支持主动型门诊服务的发展。最后，需进一步聚焦于更多医院的护士培训项目能力建设。