我国分级诊疗体系“失灵”使公立医院面临巨大服务供给压力,卫生总费用快速增长使政府和医院面临成本控制压力。提高医院运营效率、降低成本成为缓解居民看病难看病贵的重要途径。本研究突破卫生经济学三大传统评价方法(成本-效果、成本-效益、成本-效用)，旨在构建可综合评价公立医院运营效率和成本的“成本/效率”评价模型并探索其应用。研究选取全国不同经济地区、不同层级公立综合医院为研究对象，针对我国医院效率分析DEA应用不规范、方法滞后的突出问题，首先采用国际主流Bootstrap-DEA方法对DEA效率值进行纠偏,科学测量医院效率和全要素生产率；其次引入全球管理调查问卷(医院版)，应用“定性访谈定量打分”的质性研究方法测量医院内部管理水平，从内部管理角度探寻影响医院效率和成本的原因；最后将“成本/效率”评价模型应用到医院绩效改进、成本控制、医改效果评价等多个领域。研究结果具有重大理论、应用和政策价值。

Public hospitals in China are faced with big pressure in providing services resulting from the system misfunction of differentiated health care services provision. The rapid growth of total health spending also compels both government and hospitals to control cost. Improving hospital efficiency and at the same time reducing cost have become an important approach to alleviate both the difficulty of access to care and expensive care. This research goes beyond the three traditional assessment methods (cost-effectiveness, cost-benefit and cost-utility) and aims to construct a comprehensive “cost/efficiency” assessment model to assess the operational efficiency and cost of public hospitals, as well as to explore its potential application. General public hospitals of different grades distributed in different economic regions of China will be selected as the study subjects. Considering the nonstandard use of DEA and the lagged behind research method existing in current Chinese hospital efficiency studies, in this research, we will first adopt Bootstrap-DEA method that has been widely applied worldwide to adjust the bias of efficiency scores so as to scientifically measure hospital efficiency and productivity; then the World Management Survey (Hospital Version) will be introduced to measure hospitals’ internal management levels, which will be scored after qualitative interviews, so as to explore internal management factors affecting hospital efficiency and cost . At last, the “cost/efficiency” assessment model will be applied to fields including hospital performance improvement, cost control, health reform effectiveness assessment, etc. The findings will have significant theoretical, practical and policy values.