Evaluation and analysis of hospital efficiency in China based on macro- and micro-level analyses

Abstract

To explore the efficiency of Chinese hospitals at the macro and micro levels during 2011–2015. A national evaluation of hospital efficiency in China (macro level) was carried out based on hospital data from 31 provinces. Furthermore, Tianjin was selected as a field research site (micro level). Dynamic and static evaluations were conducted based on data envelopment analysis (DEA). Data were collected from the Health Statistical Yearbook and governmental departments. Hospitals were DEA-effective or weakly effective in 20 provinces. Hospitals in 64.5% of the provinces exhibited technical efficiency (TE), whereas hospitals in 11 provinces had investment resources that had not been fully utilized (TE < 1). In addition, 20 provinces had inefficient scale efficiency (SE). The Malmquist productivity index (MPI) during the periods 2011–2012, 2014–2015, and 2011–2015 was ≥ 1. Ten tertiary hospitals and six secondary hospitals were overall effective (OE), but six tertiary hospitals and ten secondary hospitals were not fully effective at the micro level. Hospital efficiency in China improved during 2011–2015, but with geographical differences. Half of the hospitals in Tianjin were relatively inefficient but its tertiary hospitals had a higher quality of care.