新医改强调了公立医院回归公益性，要求对公立医院公益性内涵与外延进行研究并运用定性与定量相结合的方式促进回归进程。本书以新公共服务、利益相关者理论为理论基础，阐释了我国公立医院公益性及其利益相关者，进一步明确了公立医院的相关概念，划分了新中国成立以来我国公立医院公益性的展现历程，梳理分析了影响我国公立医院公益性展现的关键因素。在此基础上，本书确立了公立医院公益性评价指标体系，运用未确知测度理论构建了公立医院公益性评价模型，并进行纵向及横向的实例评价，最后阐述了公立医院回归公益性的途径，对我国新医改尤其是正在深化的公立医院回归公益性改革具有一定的理论和实践指导意义。

Based on the public welfare guided background of implementing the pilot policies of Drug Addition Abolishment，increase in governmental financial compensation and adjustment in price of medical service in the new health reform in China，the research synthesizes the perspectives of both public welfare and efficiency for the first time to define the public welfare efficiency of public hospitals as medical cost efficiency，scale efficiency，technical efficiency and medical service efficiency.With consideration of the background of returning to public welfare for public hospitals，the research theme focuses on the supervision of public welfare efficiency for public hospitals in China through the perspective of management engineering.Since previous related literatures have failures in both research contents，approaches and directions，there is still room for further exploration.First，taken the perspective of research contents，isolated researches on hospital output efficiency，medical costs and public welfare regulation are presented rather than the exploration of hospital operation mechanism with integration of efficiency and public welfare.Second，from the perspective of research approaches，the researches of medical costs and its influencing factors mostly apply the classical regression models for analysis and lack the dynamic model with data-oriented for further exploration since the classical regression models are subject to strict hypothesis and can not avoid the modeling limitation of econometrics.Furthermore，DEA model and SFA model with the objective functions to maximize output with given inputs or to minimize inputs with given outputs are mainly applied to assess the hospital output efficiency rather than the public welfare efficiency.As commonweal institution，public hospitals should pursue not only itself economic efficiency but also the equal social efficiency.Third，there is little study puts forward possible implementation measures on Drug Addition Abolishment and increase in governmental financial compensation to supervise the promotion of public welfare efficiency for public hospitals.Besides the classical DEA approach，the book will apply some data-oriented models such as the quantile panel model，semiparametric LCLS and LLLS models，nonparametric path-converged model，nonparametric environmental linkage model and supervision design model to first identify the public welfare efficiency（medical cost efficiency，scale efficiency，technical efficiency and medical service efficiency）of public hospitals，and further design specific and different public welfare measures（how to increase the governmental financial expenditure and set the pharmaceutical service fee ）for different hospitals to fill the efficiency gap due to Drug Addition abolishment，so as to realize the public welfare efficiency supervision for each public hospital eventually.Specifically，the book firstly applies the quantile panel model and semi-parametric regression models on sample data of national and regional medical care expenditure per capita and average medical expenditure in public hospitals to obtain the medical cost efficiency under public welfare with the linkage change of medical care expenditure per capita due to the public welfare policies，the decisive and control variables of average medical expenditure for patients in public hospitals；secondly，the book applies the classical DEA model，nonparametric path-converged and environmental linkage models to identify the public welfare scale efficiency，technical efficiency and medical service efficiency.The main identification conclusions are listed as below.First，the medical cost efficiency research under public welfare involves the efficiency study on medical care expenditure per capita due to public welfare improvement policy and the identification of decisive factors of average medical expenditure for patients.A.The research on whether the increase in governmental financial inputs will reduce medical care expenditure per capita significantly with application of quantile panel model comes to some different and innovative results.At the quartiles of 80 percent and 90 percent，the medical care expenditure per capita is subjected to negative impact due to governmental financial inputs，and the negative impact is strengthened gradually.While at the quartiles of 10，20，50，60 and 70 percent，the medical care expenditure per capita witnesses positive impact due to governmental financial inputs.The regional difference in medical care expenditure per capita is presented by the regional fixed effect，which illustrates that the medical care expenditure per capita in Eastern region is higher than the one in Middle and Western regions.All the above facts imply that different regions（different quantities）should adopt different strategies（increase governmental financial inputs or not）to reduce the medical care expenditure per capita. B. Allowing for data structure-oriented model in regions rather than a uniform and definite model for underlying structure，the semi-parametric framework with LCLS and LLLS techniques examines and distinguishes the determinants of average health expenditures in China to linear decisive and nonlinear control variables.The identification finds out that both linear decisive and nonlinear control variables vary greatly for regional average health expenditures for inpatients（outpatients），indicating different strategies should taken to control medical average health expenditures for inpatients（outpatients）for each region.Second，DEA approach is applied to identify output efficiency of 14 provincial hospitals in Zhejiang province in 2007.The identification classifies the 14 provincial hospitals into efficient class hospital（Group1）and inefficient class hospital（Group2）.The public welfare scale efficiency is conducted by both endogenous driven factor and conduction mechanism analyses.The initial Drug Addition promotes the production driven role of labor，which is consists of the number of outpatients and emergency visits and the number of discharged inpatients.The fact implies that initial Drug Addition enhances the leading demand due to medical service and hence drives the total income of public hospitals.However，the initial Drug Addition brings about negative impact on total scale efficiency significantly，which reflects severe defect in public welfare of public hospitals.The design of pilot strategy with combination of Drug Addition Abolishment by 30 percents and governmental financial compensation will reduce the medical service efficiency while enhance the public welfare scale efficiency significantly for public hospitals.Third，the research of public welfare technological progress and efficiency improvement clearly identify the technological progress and efficiency improvement due to governmental investment with the monthly data of provincial hospitals in Zhejiang province during 2005-2008，which is greatly different to the failures of both classical Malquist index approach and linear regression estimation.The application identification results show the effectiveness of governmental investment with success during periods 2008.07-2008.12 since it successfully promotes the technical progress from the benchmark level of 0.9 percents to the path level of 29.6% and realizes a productivity promotion of 32.8 percents eventually，while the governmental investment is ineffective during period 2006.11-2008.06 with declining technical progress.Initial Drug Addition policy and governmental financial compensate during period 2011.02-2013.06 have strong positive and negative role on exogenous technical progress respectively.The design of pilot strategy with combination of Drug Addition Abolishment by 30 percents still has a gradually promotion role on technical progressduring 2010.01-2013.06，while the promotion strength is greatly weaken compared to initial Drug Addition path level.Forth，the research of medical service efficiency under public welfare applies the nonparametric environmental linkage model to innovatively identify the conduction mechanism of medical service efficiency through conduction style and conduction effect.Different environment factors exert different roles on conduction style.1.Both personal expenditures and governmental fiscal inputs promote the production efficiency of labor input，with the conduction strengths reaching 2.55% and 16.58%.2.Running cost and health price index hardly promote the production efficiency of labor input，which presents strongly evidence that government should raise medical service price so as to adjust the price distortion due to different environmental factors.Fifth，the supervision design on public welfare efficiency is carried out by filling the efficiency gap due to Drug Addition Abolishment with application of path converged model and path-environmental model.Different from previous researches on keep total output Y unchanged，the thesis focuses on keeping the driven roles of factor K and L under drug path unchanged，and furthermore determines which factor（K or L）can be applied to compensate the output efficiency gap with abolishment of Drug Addition Policies based on transmission mechanism.The specific supervison design on increasing governmental fiscal subsidies to compensate the output efficiency gap with abolishment of Drug Addition Policy are carried out for hospital H2 and H8 through enhancing the transmission mechanism of capital and labor respectively；and supervison design on simultaneously setting pharmaceutical additional service fee and increasing governmental fiscal subsidies to compensate the output efficiency gap with abolishment of Drug Addition Policy is carried out for hospital H4 through enhancing the transmission mechanism of capital.The book contains four innovations.First，the research synthesizes the perspectives of both public welfare and efficiency for the first time to define the public welfare efficiency of public hospitals as medical cost efficiency，scale efficiency，technical efficiency and medical service efficiency，which is different from previous isolated researches.The book not only identifies the public welfare efficiency，but also carries out supervision design on public welfare efficiency from the perspective of management engineering.Second，the approaches of quantile panel model，LCLS，LLLS，nonparametric path model and environmental path model do not put assumptions on population distributions and constructed with data-driven oriented perspective，which can identify the public welfare efficiency more reasonably. Third，the book identifies the driven effect of public welfare efficiency due to Drug Addition innovatively through the relative change of endogenous efficiency，scale efficiency，technical efficiency under public welfare.Forth，the supervision design of public welfare efficiency is firstly carried out with the compensation of efficiency gap due to the Drug Addition Abolishment.Different from previous researches on keep total output Y unchanged，the thesis focuses on keeping the driven roles of factor K and L under drug path unchanged，and furthermore determines which factor can be applied to compensate the output efficiency gap with abolishment of Drug Addition Policies based on transmission mechanism.Key words:Public hospital;Public welfare efficiency;Supervision design;Drug Addition Abolishment;Governmental financial compensation

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