Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA.

Zhensheng Chen,Kaixuan Bai,Lixin Cui,Xiaoqing Gan,Xueli Chen,Tomas Baležentis

doi:10.3390/ijerph17249383

Abstract

Many countries are facing the increasing cost of healthcare services and the low efficiency of public hospitals. These issues are also evident in China. This paper offers a comprehensive assessment of the efficiency of public hospitals operating in China’s 31 regions. The impact of the third round of reform of the health system in 2009 is assessed based on the three-stage data envelopment analysis procedure. The time period from 2011 to 2018 is covered in this study. Due to different functions performed by the public hospitals and other ones, the number of patients with infectious diseases is incorporated as an output variable reflecting the social function. The outpatient visits and inpatient visits are considered to reflect the outputs related to the private functions. The results imply an increase in the mean efficiency of public hospitals from 0.927 to 0.981 after taking the impact of environmental variables and statistic noise into account. These results indicate that the efficiency of public hospitals is dependent in the operational environment. There are 11 regions whose hospitals operate on the efficiency frontier during the whole period covered. Therefore, the Chinese government should reasonably design and apply the regulatory tools to improve the efficiency of public hospitals.

Highlights

It is the increasing cost of health care services delivery that has caused concerns in some countries.China has faced such challenges
The performance of regional public hospitals in China slightly decreased during the period of 2011–2018 as the mean efficiency score declined from 0.926 in 2011 down to 0.915 in 2018
The three-stage Data envelopment analysis (DEA) was employed to assess the efficiency of public hospital performance across regions in China during 2011–2018

Summary

Introduction

It is the increasing cost of health care services delivery that has caused concerns in some countries. China has been experiencing an increase in population, rapid aging of the population and improvement of living standards of residents. All of these factors have led to the increasing demand for health services. Of the economy in 2014, so it is impossible to increase the supply of health services through building new medical institutions and expanding the operation scale of hospitals as before. The health system and institutions are forced to adapt to the changes in economy, society, market, and regulation

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Conclusion