Efficiency Evaluation and Spatial Autocorrelation Analysis of Primary Health Care Resources Distribution: The Panel Three-Stage DEA Model

Abstract

Objective: To analyse the distribution of Primary Health Care (PHC) in efficiency among provinces from 2010 to 2019 in China, to examine the factors influencing performance, and to describe the spatial agglomeration characteristics of allocation efficiency, so as to optimize and balance the utilization thereof. Method: Using a panel Three-stage DEA comparative analysis model to describe factors that may lead to high efficiency, combined with a descriptive study for spatial agglomerating features of provinces using Spatial autocorrelation analysis. Results: The overall performance of PHC distribution efficiency is unreasonable, with an average comprehensive technical efficiency of 0.688 from 2010 to 2019. The external and management noise had a significant impact on the efficiency of PHC resource allocation. The increase in per capital GDP could enhance the efficiency, but the dependence ratio of the elderly population and the rate of urbanization were inversely. The effectiveness of PHC allocation had spatial agglomeration features. Moran’s I index was the lowest in 2016 (0.293) and the highest in 2019 (0.421) at the significance level of 1%. The Getis_Ord GI* index demonstrates that the general level of spatial agglomeration had improved, with the number of cluster provinces increasing from 11 to 15. Conclusion: The PHC distribution efficiency should be improved, the establishment of balanced eastern, central and western regions should be encouraged, and a new PHC ecosystem should be established. Further, new patterns should be created in the geographic area of primary health care, and citizens’ access to medical services should be increased.