Abstract
Performance of healthcare service includes quality and efficiency, so there is inevitably an association between them. In general, it is believed that there is a trade-off between quality and efficiency; however, we prove that it is not completely accurate. We take the quality as an additional output to measure the healthcare service efficiency creatively, and discuss the association between quality and efficiency based on the effect of quality on relative efficiency. Firstly, we use TOPSIS method to calculate relative quality index values of healthcare service of 31 provinces of mainland China. This practice ensures the consistent comparison of 31 provinces’ qualities. Subsequently, we measure the 31 provinces’ relative performances and efficiencies of healthcare service with consideration of quality or not, by constructing DEA models. Then, we analyze the association between quality and efficiency from each group of the national, east, central and west, and conclude that the association between them is different along with their advantage degrees of quality and efficiency. Finally, we use the Tobit regression method to test 12 environment variables’ net impacts on efficiency values both with consideration of quality or not. The results indicate that the main drivers of healthcare service efficiency are different when we take quality as an additional output or not. This article contributes to the field of performance measurement of healthcare service, puts forward a new method to integrate quality and efficiency and provides management guidelines.
Highlights
Healthcare has widespread influences on all aspects of society
The coefficient is positive (0.075) for E and negative (−0.308) for Q-E. These coefficients denote that environment variable Z1 has a positive effect on efficiency of healthcare service without considering the quality, but it has a negative effect on the performance when we take the quality as an additional output
The quality of healthcare service is directly related to the final utility of the service
Summary
Healthcare has widespread influences on all aspects of society. In the national conference on health and wellness, which had been held in Beijing from 19–20 August 2016, China’s President Xi Jinping stressed that “health is a necessary requirement of promoting the people’s all-round development, the basic condition for economic and social development, an important symbol of prosperity of the nation and country, and the common pursuit of the people”. The Chinese government has been promoting healthcare reforms according to social development, and attaching great importance to people’s health since the reform and opening up in 1978. The main target of China’s new healthcare reform, which has been implemented in January 2009, is to solve the issue of “medical treatment is difficult and expensive” [2]. This issue is mainly caused by the problem existed in medical resources allocation and operation management of hospitals [3]. Improving healthcare system’s efficiency, service level and quality are the main principles and objectives in each stage of the implementations and advices of deepening the healthcare reform in China
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