Operational efficiency of county level public hospitals in Hubei: a Bootstrap-data envelopment analysis

Abstract

Objective To estimate the operational efficiency of 37 county level public general hospitals in Hubei province using the world popular method of Bootstrap-data envelopment analysis.The aim is to make up for the theory and methodology gaps on DEA research for hospitals in China, and to provide policy and management recommendations for their further improvement. Methods The input and output indicators of hospital efficiency evaluation were selected based on our previous research.R Software was used to describe the current input and output indicators, while FEAR package used to measure Bootstrap-DEA efficiency value of the sample hospitals with bias corrected, along with such applied analysis as efficiency benchmarking for the technical efficiency outcomes. Results There are great differences among the healthcare input and output of these hospitals.In particular, the difference in the number of actual beds was 4.67 times between the highest hospital and the lowest one.All of the bias corrected efficiency scores were lower than those before correction, and the average bias corrected score of the sample hospitals is 0.717 9.Moreover, only 20 hospitals(54.05%)have their efficiency scores above the median level. Conclusions The healthcare resources allocation of these hospitals needs to be further optimized.Hospitals still have big potential to improve their efficiency.Besides providing policy support, the government is advised to guide hospitals to innovate their management mechanisms, such as introducing and applying benchmarking, ranking, inter-hospital learning among others, so as to continuously improve their operational efficiency. Key words: Bootstrap-DEA; Hubei province; County-level public hospitals; Operational efficiency; Benchmarking management