한국생산성학회

The purpose of this study is to evaluate the efficiency and productivity change of Regional Public Hospitals in applying DEA and Global Malmquist productivity index and identify variables affecting productivity changes through panel regression analysis. Data used for this analysis consisted of financial statements and the managerial performance data of 34 Regional Public Hospitals from 2015 when the MERS outbreak occurred to 2020 when the COVID-19 situation was prevalent. It was found that few papers studied changes in efficiency and productivity of Regional Public Hospitals using the latest data. Therefore, the results of this study using the latest data can be used not only for management evaluation of Regional Public Hospitals, but also for the implementation of efficient provision in public medical care through government support policy directions and cooperation with private medical institutions. We found, as a result of the study, first that medical personnel, expenses, and medical revenue of regional medical centers increased every year, and medical revenue increased by 45% and cost by 32% on average in 2019 compared to 2015. On the other hand, the number of beds increased by only 4% in 2019 compared to 2015, and it seems that the external scale expansion of Regional Public Hospitals after the MERS outbreak in 2015 was actually insignificant. Second, as a result of analyzing the operational efficiency using the DEA technique, it was found that Regional Public Hospitals had shown an average of 2-4% scale inefficiency(SE) from 2015 to 2019 and the technical efficiency of Regional Public Hospitals was more affected by the scale efficiency than the pure technical efficiency. It is judged that the operational efficiency has generally improved as the medical income of Regional Public Hospitals has increased due to policy factors such as the introduction of the new diagnosis-related group(DRG). Meanwhile, the COVID-19 in 2020 had a negative impact on the efficiency indicators of all local medical centers, including the efficiency group. Third, as a result of the global Malmquist Productivity Index (MPIG) analysis, the productivity of Regional Public Hospitals had improved from 2015 to 2019, and that productivity improvement during this period had been more affected by Best Practice Change(BPC) than by efficiency change (EC). EC occurred through management efficiency improvements such as cost reduction and staff reduction, whereas technical changes were caused by continuous and long-term phenomena such as government policy changes, the introduction of the latest equipment, the application of new technologies, and the modernization of hospital facilities. In addition, the decrease in the productivity index of regional medical centers in 2020 was due to a significant decrease in the number of inpatients and outpatients at regional medical centers due to the impact of COVID-19. Fourth, the results of panel regression analysis using a fixed model showed that medical personnel and costs negatively had effected to the change in the productivity index. In order to improve productivity, it is necessary to reduce costs due to reasonable manpower management and appropriate personnel cost, and to find ways to efficiently utilize manpower through attracting patients and increase medical profits. Based on a result of the above study, the following implications could be derived to improve the operational efficiency and productivity of Regional Public Hospitals. Regional Public Hospitals should adjust the size according to their environmental characteristics and maintain balanced resource input and allocation to improve the performance efficiency and productivity. Also, the central and local governments need to develop the policies supporting Regional Public Hospitals that can continue even after the COVID-19 situation is over. It is the time when the central government and local governments need an active support policy for the chronic deficit problem of local medical centers and the external expansion of hospital beds, medical personnel, and medical equipment. In the face of a national crisis such as the recent COVID-19, the role and necessity of Regional Public Hospitals as a provider of public health care to local residents is being emphasized more and more. The results and implications of this study will be suggestions for the expansion plan of public health currently being discussed in the government.