A study on performance evaluation of surgical departments in tertiary public hospitals based on the fuzzy combination-DEA method

Background: Tertiary grade-A public hospitals serve as key concentrations of high-quality medical resources in China. However, the allocation of resources within these hospitals remains a concern, with surgical departments facing particular challenges in both service capacity and operational efficiency, potentially hindering the provision of high-quality care. Therefore, this study aims to explore an appropriate comprehensive evaluation method for assessing the operational efficiency and service capacity of surgical departments in public hospitals, thereby providing a decision-making basis for specialty development. Methods: Based on key performance indicators for public hospitals, the service capacity of surgical departments in a tertiary hospital was evaluated using the entropy-weighted TOPSIS method combined with the Rank Sum Ratio (RSR) method through fuzzy integration, while operational efficiency was assessed using Data Envelopment Analysis (DEA). A comprehensive analysis of departmental effectiveness was conducted using the Boston Matrix. Results: In terms of medical service capacity evaluation, five ranking results were obtained using the fuzzy integration method. The top three departments were consistently A, B, and C, while the bottom two were consistently R and S. Regarding operational efficiency evaluation, the overall operational efficiency of the 19 surgical departments was 0.835. Nine departments were DEA-efficient, while ten were DEA-inefficient. Comprehensive analysis using the Boston Matrix revealed: Departments A, B, D, and I were high-efficiency, high-capability departments, demonstrating strong medical service capacity and high operational efficiency. Departments G, K, L, P, Q, R, and S were high-efficiency, low-capability departments, exhibiting relatively high operational efficiency but insufficient medical service capacity. Departments C, E, and F were low-efficiency, high-capability departments, with strong medical service capacity but inadequate operational efficiency. Departments H, J, M, N, and O were low-efficiency, low-capability departments, showing both insufficient medical service capacity and low operational efficiency. Conclusion: The evaluation results obtained from the entropy-weighted TOPSIS method and the fuzzy combination of the Rank-Sum Ratio (RSR) method demonstrated a high degree of consistency. When combined with DEA-based efficiency assessment, these methods enable a more scientific and precise evaluation of surgical department effectiveness from two distinct dimensions, thereby providing a robust decision-making basis. Surgical departments in the sample hospital should prioritize technological advancement and the optimization of talent structure, shifting the focus of resource allocation from "incremental expansion" to "structural optimization".