Abstract: Background　As township hospitals undertake the main work in mental health prevention and treatment in rural areas，it is crucial to evaluate whether their mental health services efficiency meets the maximum demand，but rare relevant studies can be found currently. Objective　To evaluate the mental health services efficiency in township hospitals in Guangxi using data envelopment analysis（DEA），aiming to provide references for the application of DEA in mental health management evaluation. Methods　From January to June，2018，15 counties were randomly selected according to geographical distribution and economic development level in Guangxi，and from each 3 township hospitals were extracted by population-based sampling，and finally 45 township hospitals（A1-A45） in total participated in our questionnaire survey. A self-designed questionnaire named Mental Health Services Performance in Township Hospitals was used，which includes the general status of townships，financial investment and human resource for mental health services delivery，and file documenting，standardized management，regular medication and condition stability of the patients with severe mental disorders. Financial investment and the number of mental health workers（including part-time workers） were selected as input indicators，and the proportions of the file documenting，standardized management，regular medication and condition stability of the patients were applied as output indicators based on policy research and literature review. The output-oriented BCC model was employed to analyze the relative efficiency of mental health services delivery，and to calculate the projection value of each indicator. Results　The survey achieved a response rate of 100.0%. The average overall technical efficiency（OTE） of the 45 township hospitals in delivering mental health services was 0.450，among which the hospital coded as A7 had the lowest（0.109）. The pure technical efficiency was 0.956 on average，of which the hospital coded as A8 had the lowest（0.710）. The scale efficiency was 0.462 on average，of which the hospital coded as A38 owned the lowest（0.125）. Only 6（13.3%）hospitals（coded as A3，A21，A22，A28，A34，A36） were relatively efficient，with OTE，pure technical efficiency and scale efficiency reaching 1.000. 23（58.97%） were pure technically efficient in relative（pure technical efficiency=1.000）. 39（86.7%） presented decreasing returns to scale. To improve the efficiency of 39 inefficient township hospitals，the proportions of the file documenting，standardized management，regular medication and condition stability of the patients with severe mental disorders need to be improved by 0.29‰，8.63%，8.02% and 6.06% on average，respectively. Conclusion　The overall efficiency of mental health services delivery is low in township hospitals of Guangxi. And there exist some issues such as insufficient utilization and inappropriate composition and allocation of mental health resources，low scale efficiency，and decreasing returns. Besides，inappropriate mental health management of patients with severe mental disorders and internal management and quality control of township hospitals are also problems. And the output of the mental health services delivery still has much room for improvement. To enhance the efficiency of mental health services delivery，available mental health resources should be effectively allocated and used with optimized composition，and the development of sound hospital culture and working mechanism should be strengthened.

Key words: Mental health services；Data analysis, statistical；Data envelopment analysis；Community health services；Suburban health services；Efficiency

摘要： 背景　乡镇卫生院是开展农村精神卫生防治工作的主要力量，研究其精神卫生服务效率是否达到最佳状态对推进精神卫生事业发展有重要意义，但目前罕有相关文献。目的　采用数据包络分析（DEA）评价广西乡镇卫生院的精神卫生服务效率，为基层精神卫生事业的发展提供参考，为DEA在精神卫生领域的应用提供参考。方法　2018年1—6月，按广西的地理分布和经济发展水平，随机抽取15个样本县；在每个样本县，以人口作为标识，采用系统抽样的方法抽取3个乡镇卫生院；最终共抽取45个乡镇卫生院（分别为A1~A45）为调查对象。采用自制“乡镇卫生院社区精神卫生服务绩效评估问卷”进行调查，调查内容包括2017年广西乡镇卫生院的基本情况、精神卫生经费投入、精神卫生服务人力资源，以及严重精神障碍患者建档、规范管理、规律服药、病情稳定情况。通过政策研究和文献研究选取精神卫生经费投入和精神卫生人员（含兼职人员）为投入指标，严重精神障碍患者建档率、规范管理率、规律服药率和病情稳定率为产出指标，运用产出导向的BCC模型分析精神卫生服务效率的相对有效性，并计算各项指标的目标值。结果　共发放问卷45份，回收有效问卷45份，有效回收率为100.0%。45个乡镇卫生院精神卫生服务的平均技术效率（综合效率）为0.450，其中A7最低（0.109）；平均纯技术效率为0.956，其中A8最低（0.710）；平均规模效率为0.462，其中A38最低（0.125）。只有6个乡镇卫生院（A3、A21、A22、A28、A34、A36）技术效率、纯技术效率和规模效率同时为1.000，即精神卫生服务效率相对有效，占13.3%。有23个乡镇卫生院的纯技术效率达到相对有效（纯技术效率=1.000），占58.97%。从规模报酬来看，有39个乡镇卫生院规模报酬处于递减状态，占86.7%。39个非DEA有效乡镇卫生院的严重精神障碍患者建档率还可以平均再提高0.29‰，严重精神障碍患者规范管理率还可以平均再提高8.63%，严重精神障碍患者规律服药率还可以平均再提升8.02%，严重精神障碍患者病情稳定率还可以平均再提升6.06%。结论　广西乡镇卫生院的精神卫生服务效率整体较低，存在当前精神卫生资源利用不足、结构和配置不合理、规模效率低下、精神卫生服务产出的增长速度低于投入的增长速度等问题，且严重精神障碍患者的管理不到位，乡镇卫生院的内部管理和质量控制存在不足，精神卫生服务的产出还有较大的提升空间。建议有效利用当前精神卫生资源，并优化结构，改善配置，加强乡镇卫生院内涵建设，建立健全工作机制，以提升精神卫生服务效率。

关键词: 精神卫生服务, 数据分析, 统计, 数据包络分析, 社区卫生服务, 郊区卫生服务, 效率