Efficiency Of Health Resource Allocation Research Articles

Investigating the Application of Regression Discontinuity in the Field of International Health Economics

As one of the most significant quasi-experimental research methods, with over eight decades of development, Regression Discontinuity Design (RDD) has garnered extensive attention within the field of international health economics. It has provided robust methodological support for causal inference in research conducted within this domain. This paper provides a comprehensive review and synthesis of the foundational concepts, origins, and evolutionary trajectory of the RDD. It systematically examines the relevant studies in the domain of international health economics, discusses the strengths and limitations of the RDD, and anticipates its future applications in the same field. The aim is to support the utilization of RDD in international health economic research. On a theoretical level, it has effectively enhanced the flexibility and applicability of research designs within the domain of international health economics, augmenting the economic efficiency and external validity of studies, and offering a versatile tool for related research on a global scale. On a practical level, RD accommodates the diverse policy needs of programs across various countries and regions. It provides a more robust and reliable empirical foundation for the formulation of pertinent health policies, aiming to improve the efficiency of health resource allocation and promote equity in health outcomes.

Equity and efficiency of health resource allocation in township health centers in Sichuan Province, China.

To analyze the equity and efficiency of health resource allocation in township health centers in Sichuan Province, and to provide a scientific basis for promoting the development of township health centers in Sichuan Province, China. The Lorenz curve, Gini coefficient and health resource density index were used to analyze the equity of health resource allocation in township health centers in Sichuan Province from 2017 to 2021, and data envelopment analysis(DEA) was used to analyze the efficiency of health resource allocation in township health centers in Sichuan Province from 2017 to 2021. The Gini coefficient of health resources of township health centers in Sichuan Province is below 0.2 by population in addition to the number of beds in 2020-2021 and practicing (assistant) physicians in 2021, and the Gini coefficient of health resources of township health centers in Sichuan Province is above 0.6 by geography. The Lorentz curve of health resources of township health centers in Sichuan Province is closer to the equity line by population allocation and further from the equity line by geographical allocation. The average level of township health centers in Sichuan Province is used as the standard to calculate the health resource density standard index(W) of each region, the Ws of Panzhihua, Ganzi, Aba and Liangshan are less than 1, and the Ws of Ziyang, Neijiang, Deyang and Meishan are greater than 1. The overall efficiency of township health centers in Sichuan Province in 2017 and 2021 is 1, and the DEA is relatively effective. The overall efficiency of township health centers in Sichuan Province in 2018 and 2019 is not 1, and the DEA is relatively ineffective. The overall efficiency of all health resources in Mianyang and Ziyang is 1, and the DEA is relatively effective. The overall efficiency of all health resources in Suining, Neijiang, Yibin, Aba and Ganzi is not 1, and the DEA is relatively ineffective. The equity of health resource allocation by population is better than that by geography in township health centers in Sichuan Province. Combining population and geographical factors, the health resource allocation of Panzhihua, Ganzi, Aba and Liangshan is lower than the average level of Sichuan Province. The efficiency of health resource allocation in township health centers in Sichuan Province is low.

Study on the allocation efficiency of medical and health resources in Hainan Province: Based on the super-efficiency SBM-Malmquist model.

The equity and efficiency of medical and health resource allocation is the key point of health reform in all countries. Poor allocation efficiency of health resources will seriously affect the sustainable and high-quality development of health causes. Hainan Province is the only free trade port with Chinese characteristics in China, which means that Hainan has ushered in a brand-new development under the policy of free trade port. This study aims to adopt policies to improve the efficiency of medical and health resource allocation in Hainan Province and provide references for other regions. In this study, the Super-efficiency SBM and Malmquist models were used to analyze the static and dynamic efficiency of medical and health resource allocation in Hainan Province during 2016-2020. The results showed that, statically, the average efficiency of comprehensive allocation of health resources in Hainan Province from 2016 to 2020 was 0.975, showing poor overall performance and significant regional differences. Dynamically, the average index of allocation efficiency of medical and health resources was 0.934, showing a negative growth trend. The technical efficiency and scale efficiency of health resource allocation efficiency showed positive growth, while the technical progress and pure technical efficiency showed negative growth. It shows that it is influenced by both scale efficiency and technological progress, among which technological progress is the key factor. Therefore, some policy suggestions are put forward to further optimize the allocation of medical and health resources and improve utilization efficiency.

The efficiency of health resource allocation and its influencing factors: evidence from the super efficiency slack based model-Tobit model.

This study aims to analyze the health resource allocation efficiency in Sichuan Province from 2010 to 2018 and provide other countries with China's experience. We used the super efficiency slack based model (SBM) model and Malmquist index to analyze the super efficiency and inter-period efficiency of health resource allocation in 19 cities in Sichuan Province from 2010 to 2018 and propose the input-output optimization scheme of health resource allocation in 2018. Finally, the Tobit model was used to estimate the influencing factors of health resource allocation efficiency. The total allocation of health resources in Sichuan Province was increasing in addition to the total number of visits from 2010 to 2018. The super efficiency SBM results identified that the sample's average score was between 0.651 and 3.244, with an average of 1.041, of which 15 cities had not reached data envelopment analysis effectiveness. According to the Malmquist index, the average total factor productivity index of Sichuan Province was 0.930, which showed an imbalance in resource input, and its fluctuation was mainly related to the technological progress index and scale efficiency. The efficiency score was affected by the average annual income of residents, population density and education level. The amount of health resource allocation in Sichuan Province had shown an overall upward trend since 2010. However, resource allocation efficiency was not high, and there were problems such as significant regional differences, insufficient technological innovation capabilities and unscientific allocation of resource scale. To optimize the resource allocation structure, we suggest that the relevant departments pay attention to the impact of natural disasters, the average annual income of residents, population density and education level on efficiency to allocate health resources scientifically.

Effective Analysis of Inpatient Satisfaction: The Random Forest Algorithm.

PurposeTo identify the factors influencing inpatient satisfaction by fitting the optimal discriminant model.Patients and MethodsA cross-sectional survey of inpatient satisfaction was conducted with 3888 patients in 16 large public hospitals in Zhejiang Province. Independent variables were screened by single-factor analysis, and the importance of all variables was comprehensively evaluated. The relationship between patients’ overall satisfaction and influencing factors was established, the relative risk was evaluated by marginal benefit, and the optimal model was fitted using the receiver operating characteristic curve.ResultsPatients’ overall satisfaction was 79.73%. The five most influential factors on inpatient satisfaction, in this order, were: patients’ right to know, timely nursing response, satisfaction with medical staff service, integrity of medical staff, and accuracy of diagnosis. The prediction accuracy of the random forest model was higher than that of the multiple logistic regression and naive Bayesian models.ConclusionInpatient satisfaction is related to healthcare quality, diagnosis, and treatment process. Rapid identification and active improvement of the factors affecting patient satisfaction can reduce public hospital operating costs and improve patient experiences and the efficiency of health resource allocation. Public hospitals should strengthen the exchange of medical information between doctors and patients, shorten waiting time, and improve the level of medical technology, service attitude, and transparency of information disclosure.

Analysis of health resource allocation efficiency of township hospitals in China

This paper aims to analyze the distribution of health resources in township hospitals in China from 2015 to 2018, and to provide Suggestions for improving the utilization efficiency of health resources in township hospitals by selecting 29 provinces/autonomous regions/municipalities directly under the Central Government (except Beijing and Shanghai) as the research objects. DEA-BCC model and DEA-Malmquist index model were used to analyze the utilization efficiency of health resources allocation in China’s township health centers. Results are In 2018 in the country, 29 provinces, cities and towns and townships, the comprehensive technical efficiency, pure technical efficiency and scale efficiency of mean value of the allocation of health resources is respectively 0.585, 0.751, 0.802, including Tianjin, Jiangsu, Zhejiang, Qinghai, Ningxia and other regions with theirs comprehensive efficiency be 1, DEA, being relatively effective, the comprehensive efficiency of other 24 regions are less than 1, being weak DEA efficient or relatively invalid; From 2015 to 2018, the average total factor productivity index of township health centers in nationwide was 0.979, with an average decrease of 2.1%, the change index of technical efficiency decreased by 1.3%, and the technological progress index decreased by 0.9%. It comes to a conclusion the level of overall resource allocation efficiency of township health centers in China is low with an unbalanced overall resource allocation, and the total factor productivity as a whole shows a downward trend. It is necessary to rationally plan the distribution of health resources in township hospitals, to increase technical input, improve the overall level of medical services, and balance the differences among regions, update the management concept of township health center managers, promote smart medical treatment and fine management, strengthen financial support and policy preference, promote the technological progress of township hospitals, and improve the efficiency of health resources use.

Equity and Efficiency of Health Resource Allocation of Chinese Medicine in Mainland China: 2013-2017.

Background: In this study, we aimed to estimate the equity and efficiency of traditional Chinese medicine (TCM) health resource allocation, utilization, and trend in mainland China from 2013 to 2017.Methods: The data were downloaded from the China Health Statistical Yearbook (2014–2018) and the China Statistical Yearbook (2018). The equity of TCM health resource allocation was evaluated through the Lorenz curve, Gini coefficient (G), and Theil index (T) based on population size and geographical area. The efficiency and productivity of TCM health resource utilization were assessed using the data envelopment analysis-based Malmquist productivity index.Results: TCM health resource had an increasing trend every year. The equity allocated by population (G ranging from 0.1 to 0.3) was better than that by geographic region (G > 0.5). T in the intra-groups was higher than those in the inter-groups. The equity of TCM resource allocation was the middle region > eastern region > western region. Most provinces (29 out of 31) had negative productivity changes, suggesting deterioration in productivity. Moreover, the middle region with higher scale sizes had more redundant inputs than the other two regions. However, the low technological development (all technical values <1) might hinder productive progress.Conclusion: The equity of TCM health allocated by the population was better than that by the geographic region. The intra-regional difference was the main reason for inequity sources. Productivities in more than 97% of provinces are inefficient. The frequency distribution of scale efficiency (score > 1) had increased since 2015. However, the frequency distribution of technical change (score > 1) decreased every year. The slow technological progress and low scale size might be the main reasons for low productivity.

Evaluation of quality of pharmacoeconomic studies involved in traditional Chinese medicine in China

ABSTRACT Objectives The pharmacoeconomic studies of traditional Chinese medicine (TCM) are still in its infancy. Assessing the quality of pharmacoeconomic studies of TCM to improve the efficiency of health resource allocation and guide the rational use of medicine. Methods Four databases were searched from inception to January 2018. The Consolidated Health Economic Evaluation Reporting Standards statement (CHEERS) and the Quality of Health Economic Studies (QHES) were used to assess the reporting quality and methodological quality. STATA 12.0 and Meta analyst 3.13 were used to analyze the related data. Results A total of 178 studies were included. The methodological evaluation of the study found that the total score of QHES was 47.85 ± 8.09. The report quality evaluation results found that many studies did not report comprehensive information, such as lack of detailed reports on abstracts, study perspectives, time frames, discount rates, model selection, but the titles, study background and location, and health results, resource and cost estimates, analysis methods, and heterogeneity analysis are reported in more detail. Six of the ten stratification factors have statistically significant differences. Conclusion The overall quality of pharmacoeconomic studies of TCM is low, and further standardization and improvement are needed to obtain reliable study results.

Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China

BackgroundWhile the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China’s Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight.MethodsUsing a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province.ResultsWe observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province.ConclusionsThe government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

Evaluation on equality and efficiency of health resources allocation and health services utilization in China

BackgroundChina is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China.MethodsDemographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012–2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012–2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation.ResultsFrom 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from −0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively.ConclusionsThere exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource investments for different provinces.

Towards an equitable healthcare in China: evaluating the productive efficiency of community health centers in Jiangsu Province

BackgroundWhile the demand for the health service keeps escalating at the grass root or rural areas of China, a substantial portion of healthcare resources remains stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, the Deepening Health Care Reform in 2012 China was intended to flush out these discrepancies and promote a more equitable and efficient distribution of health resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight.MethodsWe divided Jiangsu Province into 3 zones according to the level of economic and social development i.e. developed, developing, and undeveloped areas. Using a hybrid of Panel data analysis and an augmented Data Envelopment Analysis (DEA), we model human resources, capital inputs of Community Health Centers to comprehensively determine the technical and scale efficiency of community health resources in 3 zones in Jiangsu Province.ResultsWe sampled data and analysed efficiency and productivity growth of 75 Community Health Centers in 13 cities of Jiangsu Province from 2011 to 2015, which shows that a significant productive growth among Community Health Centers between 2011 and 2015. Mirroring the behavior of Community Health Centers, technological progress was the underlying force for the growth and the deterioration in efficiency change was found. This can be credited partly to the Deepening Health Care Reform measures aimed at improving technology availability in health centers in sub-urban areas. The regional summary of the DEA result shows that the stage of economic development and the efficiency performance of hospital did not necessarily go hand in hand among the 3 zones of Jiangsu.ConclusionsThe government of China in general and Jiangsu province in particular could improve the efficiency of health resources allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources and enhancing the level of health of financial resources allocation.

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China.

BackgroundThis study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China.MethodsWe analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators.ResultsThe CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the “best practice frontier”. The other 8 (25.8%) provinces were technically inefficient.ConclusionsHealth professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.

Public-private-partnership in healthcare delivery in China: policy and feasible models

This study introduced the concept of healthcare delivery PPP, and analyzed its policies.Based on such policy analysis, the authors discussed its practical model from such aspects as cooperation content, cooperation width and depth, in consideration of the special properties of healthcare delivery.The government is proposed to deepen the health reform on a whole while encouraging PPP model in healthcare delivery in view of its impacts on the equity and efficiency of health resources allocation. Key words: Public-private-partnership; Healthcare delivery; Policy analysis; Feasibility