Service Resources Research Articles

High-Accuracy Analytical Model for Heterogeneous Cloud Systems with Limited Availability of Physical Machine Resources Based on Markov Chain

The article presents the results of a study on modeling cloud systems. In this research, the authors developed both analytical and simulation models. System analysis was conducted at the level of virtual machine support, corresponding to Infrastructure as a Service (IaaS). The models assumed that virtual machines of different sizes are offered as part of IaaS, reflecting the heterogeneous nature of modern systems. Additionally, it was assumed that due to limitations in access to physical server resources, only a portion of these resources could be used to create virtual machines. The model is based on Markov chain analysis for state-dependent systems. The system was divided into an external structure, represented by a collection of physical machines, and an internal structure, represented by a single physical machine. The authors developed a novel approach to determine the equivalent traffic, approximating the real traffic appearing at the input of a single physical machine under the assumptions of request distribution. As a result, it was possible to determine the actual request loss probability in the entire system. The results obtained from both models (simulation and analytical) were summarized in common graphs. The studies were related to the actual parameters of commercially offered physical and virtual machines. The conducted research confirmed the high accuracy of the analytical model and its independence from the number of different instances of virtual machines and the number of physical machines. Thus, the model can be used to dimension cloud systems.

Laparoscopic cholecystectomy versus conservative management for adults with uncomplicated symptomatic gallstones: the C-GALL RCT.

Gallstone disease is a common gastrointestinal disorder in industrialised societies. The prevalence of gallstones in the adult population is estimated to be approximately 10-15%, and around 80% remain asymptomatic. At present, cholecystectomy is the default option for people with symptomatic gallstone disease. To assess the clinical and cost-effectiveness of observation/conservative management compared with laparoscopic cholecystectomy for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones in secondary care. Parallel group, multicentre patient randomised superiority pragmatic trial with up to 24 months follow-up and embedded qualitative research. Within-trial cost-utility and 10-year Markov model analyses. Development of a core outcome set for uncomplicated symptomatic gallstone disease. Secondary care elective settings. Adults with symptomatic uncomplicated gallstone disease referred to a secondary care setting were considered for inclusion. Participants were randomised 1: 1 at clinic to receive either laparoscopic cholecystectomy or observation/conservative management. The primary outcome was quality of life measured by area under the curve over 18 months using the Short Form-36 bodily pain domain. Secondary outcomes included the Otago gallstones' condition-specific questionnaire, Short Form-36 domains (excluding bodily pain), area under the curve over 24 months for Short Form-36 bodily pain domain, persistent symptoms, complications and need for further treatment. No outcomes were blinded to allocation. Between August 2016 and November 2019, 434 participants were randomised (217 in each group) from 20 United Kingdom centres. By 24 months, 64 (29.5%) in the observation/conservative management group and 153 (70.5%) in the laparoscopic cholecystectomy group had received surgery, median time to surgery of 9.0 months (interquartile range, 5.6-15.0) and 4.7 months (interquartile range 2.6-7.9), respectively. At 18 months, the mean Short Form-36 norm-based bodily pain score was 49.4 (standard deviation 11.7) in the observation/conservative management group and 50.4 (standard deviation 11.6) in the laparoscopic cholecystectomy group. The mean area under the curve over 18 months was 46.8 for both groups with no difference: mean difference -0.0, 95% confidence interval (-1.7 to 1.7); p-value 0.996; n = 203 observation/conservative, n = 205 cholecystectomy. There was no evidence of differences in quality of life, complications or need for further treatment at up to 24 months follow-up. Condition-specific quality of life at 24 months favoured cholecystectomy: mean difference 9.0, 95% confidence interval (4.1 to 14.0), p < 0.001 with a similar pattern for the persistent symptoms score. Within-trial cost-utility analysis found observation/conservative management over 24 months was less costly than cholecystectomy (mean difference -£1033). A non-significant quality-adjusted life-year difference of -0.019 favouring cholecystectomy resulted in an incremental cost-effectiveness ratio of £55,235. The Markov model continued to favour observation/conservative management, but some scenarios reversed the findings due to uncertainties in longer-term quality of life. The core outcome set included 11 critically important outcomes from both patients and healthcare professionals. The results suggested that in the short term (up to 24 months) observation/conservative management may be a cost-effective use of National Health Service resources in selected patients, but subsequent surgeries in the randomised groups and differences in quality of life beyond 24 months could reverse this finding. Future research should focus on longer-term follow-up data and identification of the cohort of patients that should be routinely offered surgery. This trial is registered as ISRCTN55215960. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/71) and is published in full in Health Technology Assessment; Vol. 28, No. 26. See the NIHR Funding and Awards website for further award information.

Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth

ObjectiveOur objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness.DesignThere were four distinct phases: codesign (focus groups and codesign workshops with...

A complex network-based approach for resilient and flexible design resource allocation in industry 5.0

The development of Industry 5.0 focuses on customization, personalization in production, and the innovative thinking of employees, elevating the value of human contribution. Design, being an innovation-driven domain, demands greater flexibility in resource allocation. Consequently, rapidly and effectively allocating cloud service resources for personalized design tasks becomes crucial. With the emergence of the Industrial Metaverse, which blurs the boundaries between real and virtual design and manufacturing, it is gaining increasing attention. To embrace the advent of Industry 5.0 and the Industrial Metaverse, swift collaborative cloud services for design and manufacturing resources are essential. In this context, this article introduces a novel approach combining complex networks with the Non-dominated Sorting Genetic Algorithm III (NSGA-III), aimed at rapidly optimizing the dynamic allocation of distributed design resources (DRs). Initially, a multipartite graph is created from raw data and mapped to multiple bipartite graphs to identify key nodes in the network through intersection. Subsequently, these key nodes are used as reference points in the NSGA-III algorithm to achieve high-quality cloud service combinations, meeting the needs of design tasks with multiple subtasks, and related multi-objective optimization, including time, cost, reliability, maintainability, and reputation associated with the design. Finally, the Pareto service combinations obtained are used to construct a new complex network and employ the Girvan-Newman algorithm based on edge betweenness to identify community structures. In case of anomalies in the best service combination, alternative options can be swiftly searched from the identified communities, thereby enhancing the resilience of the cloud service process. Experimental results demonstrate the method's advantages in recovery and robustness, contributing significantly to the optimization of rapid cloud service allocation for DRs in the context of Industry 5.0.

Architecting sustainability performances and enablers for grid-interactive efficient buildings

Today, grid-interactive, efficient buildings are gaining popularity due to their potential sustainability performances through their ability to learn, adapt, and evolve at different scales to improve the quality of life of their users while optimizing resource usage and service availability. This is realized through various practices such as management and control measures enabled by smart grid technologies, interoperability, and human-cyber-physical security. However, despite their great potential, the research of those technologies still faces various challenges. These include a lack of communication and control infrastructure to address interpretability, security, cost barriers, and difficulties balancing occupant needs with grid benefits. Initially, system modelling and simulation are promising approaches to address those challenges ahead of time. It involves consideration of complex systems made up of components from various research domains. This paper addresses the above practices, highlighting the value of integrating technology and intelligence in the planning and operation of buildings, both new and old. It provides a way to educate architects and engineers about this emerging field and demonstrates how these practices can help in creating efficient, resilient, and secure buildings that contribute to occupant comfort and decarbonization.

Research on the Path of University Sports Service for National Fitness from a Collaborative Perspective

College sports are the core part of physical education in China, and also an important foundation for both social sports and competitive sports. In national fitness, college sports play an extremely important role and position. Research has found that university sports resources serve national fitness with advantages such as sports venues, sports talents, information resources, and environmental atmosphere; There are disadvantages such as uneven resource allocation and insufficient awareness of social services. This proposes an effective development path to promote the service of university sports resources to national fitness, aiming to provide theoretical reference for better serving national fitness with university sports resources.

Tracking and Profiling Repeated Users Over Time in Text-Based Counseling: Longitudinal Observational Study With Hierarchical Clustering.

Due to their accessibility and anonymity, web-based counseling services are expanding at an unprecedented rate. One of the most prominent challenges such services face is repeated users, who represent a small fraction of total users but consume significant resources by continually returning to the system and reiterating the same narrative and issues. A deeper understanding of repeated users and tailoring interventions may help improve service efficiency and effectiveness. Previous studies on repeated users were mainly on telephone counseling, and the classification of repeated users tended to be arbitrary and failed to capture the heterogeneity in this group of users. In this study, we aimed to develop a systematic method to profile repeated users and to understand what drives their use of the service. By doing so, we aimed to provide insight and practical implications that can inform the provision of service catering to different types of users and improve service effectiveness. We extracted session data from 29,400 users from a free 24/7 web-based counseling service from 2018 to 2021. To systematically investigate the heterogeneity of repeated users, hierarchical clustering was used to classify the users based on 3 indicators of service use behaviors, including the duration of their user journey, use frequency, and intensity. We then compared the psychological profile of the identified subgroups including their suicide risks and primary concerns to gain insights into the factors driving their patterns of service use. Three clusters of repeated users with clear psychological profiles were detected: episodic, intermittent, and persistent-intensive users. Generally, compared with one-time users, repeated users showed higher suicide risks and more complicated backgrounds, including more severe presenting issues such as suicide or self-harm, bullying, and addictive behaviors. Higher frequency and intensity of service use were also associated with elevated suicide risk levels and a higher proportion of users citing mental disorders as their primary concerns. This study presents a systematic method of identifying and classifying repeated users in web-based counseling services. The proposed bottom-up clustering method identified 3 subgroups of repeated users with distinct service behaviors and psychological profiles. The findings can facilitate frontline personnel in delivering more efficient interventions and the proposed method can also be meaningful to a wider range of services in improving service provision, resource allocation, and service effectiveness.

Human–AI resource relations in value cocreation in service ecosystems

PurposeApplications of artificial intelligence (AI), such as virtual and physical service robots, generative AI, large language models and decision support systems, alter the nature of services. Most service research centers on the division between human and AI resources. Less attention has been paid to analyzing the entangled resource relations and interactions between humans and AI entities. Thus, the purpose of this paper is to extend our metatheoretical understanding of resource integration and value cocreation by analyzing different human–AI resource relations in service ecosystems.Design/methodology/approachThe conceptual paper adapts a novel framework from postphenomenology, specifically cyborg intentionality. This framework is used to analyze what kinds of human–AI resource relations enable resource integration and value cocreation in service ecosystems.FindingsWe conceptualize seven different human–AI resource relations, namely background, embodiment, hermeneutic, alterity, cyborg, immersion and composite relation. The sociotechnical entangled perspective on human–AI resource relations challenges and reframes our understanding of interactions between humans and nonhumans in resource integration and value cocreation and the distinction between operant and operand resources in service research.Originality/valueOur primary contribution to researchers and service providers is dissolving the distinction between operant and operand resources. We present two foundational propositions. 1. Humans and AI become entangled value cocreating resources in inherently sociotechnical service ecosystems; and 2. Human and AI entanglements in value cocreation manifest through seven resource relations in inherently sociotechnical service ecosystems. Understanding the combinatorial potential of different human–AI resource relations enables service providers to make informed choices in service ecosystems.

Research on Effective Supply Strategies of Informationization Teaching Resources under the Background of "Double Reduction"

The quality of education after the "double reduction" needs to be guaranteed by deepening education and teaching reform. In order to better implement the "double reduction", it is necessary to apply information technology teaching methods to promote educational reform. At the same time, deepening information technology teaching reform is also an effective measure to promote the common and balanced development of compulsory education. In the society where information technology teaching is constantly developing, information resources are everywhere. In the context of "double reduction", the study of effective supply strategies for high-quality information technology education resources is conducive to the realization of reducing burden, increasing efficiency, and improving the quality of education environment. On the basis of explaining how information technology education resources can empower the implementation of "double reduction", this study proposes effective supply strategies for information technology education resources from the perspectives of precise promotion of teaching resources and teaching services, hierarchical supply of after-school service resources, big data resources to assist school work, and transformation of service models for off campus institutions.

Research on the supply and demand of elderly care service resources in China.

This study aims to assess the current status and spatial distribution differences of elderly care service resources supply and demand in China. Semi-structured qualitative interviews were utilized to gather participants' insights into the current demands for elderly care services, the status of resource allocation, and related indicators. The entropy weight method was employed to determine indicator weights, yielding objective demand and allocation indices for elderly care service resources. Kernel density estimation was used to illustrate the distribution characteristics of the demand and allocation indices. The coupling coordination degree model was applied to measure the coupling coordination level of China's elderly care service resource supply and demand system in 2020. The demand index ranks highest in Beijing (0.3291), Shanghai (0.2941), and Tianjin (0.2563), while the lowest are found in Tibet (0.1673), Guangxi (0.1727), and Guizhou (0.1737). Kernel density estimation shows that the demand index is concentrated in the range of 0.1800 to 0.2000. The top three regions for allocation index are Shanghai (184.0007), Qinghai (129.8177), and Beijing (109.5941), with the lowest in Liaoning (34.8558), Hainan (35.3168), and Yunnan (36.6366). Kernel density estimation indicates that the allocation index is concentrated in the range of 25-75. Calculations of coupling coordination degree show that Shanghai has high coordination quality (0.9368), Beijing has good coordination (0.8392), while Hainan and Yunnan experience severe imbalances (0.1990, 0.1831). There is a significant lack of coordination between the demand for elderly care services and the allocation of resources in Hainan and Yunnan provinces in China. Most provinces, with the exception of Beijing and Shanghai, exhibit some degree of misalignment. The Chinese government should address the varying needs of the elderly population in different regions, pay timely attention to regional disparities, enhance regional cooperation, and dynamically allocate elderly care resources in a rational manner.

Editorial for Human Resources Management and Services (Volume 6 Issue 2)

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Mining for cost awareness in the infrastructure as code artifacts of cloud-based applications: An exploratory study

Context:Cloud computing’s rise as the primary platform for software development and delivery is largely driven by the potential cost savings. However, it is surprising that no empirical evidence has been collected to determine whether cost awareness permeates the development process and how it manifests in practice. Objective:This study aims to provide empirical evidence of cost awareness by mining open source repositories of cloud-based applications. The focus is on Infrastructure-as-Code artifacts that automate software (re)deployment on the cloud. Methods:A systematic examination of 152735 repositories yielded 2010 relevant hits. We then analyzed 538 relevant commits and 208 relevant issues using inductive and deductive coding and corroborated findings with discussions from Stack Overflow. Results:The findings indicate that developers are not only concerned with the cost of their application deployments but also take actions to reduce these costs beyond selecting cheaper cloud services. We also identify research areas for future consideration. Conclusion:Although we focus on a particular Infrastructure-as-Code technology (Terraform), the findings can be applicable to cloud-based application development in general. The provided empirical grounding can serve developers seeking to reduce costs through service selection, resource allocation, deployment optimization, and other techniques.

Improved student outcomes: a unique, culturally relevant, and intensive behavioral health training program

ABSTRACT The behavioral health workforce shortage is pervasive across the United States. To address this need, it is important to establish effective and culturally relevant trainings for behavioral health practitioners. This study examines the results of a Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET) funded program intended to increase the qualified workforce meeting high need and demand. Over the four-year funding of the program, 119 Masters of Social Work students graduated from the social work program with specialized training. The program was successful providing innovative training focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services.

Integrated scheduling of multi-site repair tasks considering customer preferences under a novel two-dimensional combination warranty strategy

Current warranty strategies typically focus on the interests of either the manufacturer or the customer, and fail to meet the diverse needs of the customers, as they only consider a single reimbursement or repair method. Furthermore, these strategies neglect out-of-warranty customers, resulting in a loss of profit for manufacturers. To serve both in-warranty and out-of-warranty customers, a novel two-dimensional combination warranty strategy is proposed in this paper which combines two reimbursement methods and two repair methods. Under the two-dimensional combination warranty strategy, we establish an integrated scheduling model for determining repair strategies and allocating service resources, referred to as 2DCW-MSRASM. In 2DCW-MSRASM, the manufacturer arranges appropriate warranty strategies for in-warranty orders according to the corresponding product conditions (age and usage), while for out-of-warranty customers, the manufacturer makes decisions based on its own resource situation and customer preferences. The objective of 2DCW-MSRASM is to achieve an optimal scheduling that maximizes the manufacturer’s profit and the satisfaction of both in-warranty and out-of-warranty customers. In this model, TODIM (an acronym in Portuguese of Interactive and Multi-Criteria Decision Making) is utilized to evaluate the repair services from the customer’s perspective, which considers the limited rationality of decision-makers. An improved non-dominated neighbor immune algorithm (INNIA) is developed to solve the model, incorporating an initialization method and three problem-oriented local search operators to enhance search capability. Following that, extensive experiments are conducted to demonstrate the superiority of INNIA. Eventually, the proposed strategy is demonstrated to possess noteworthy advantages when the order size is large and the proportion of in-warranty orders is high.

Energy efficient data dissemination in wireless sensor network enabled IoT using domain‐adaptive message passing graph neural network

SummaryIn the past few years, restricted wireless sensor networks (WSNs) enabled the Internet of Things (IoT) have attracted significant attention and expansion to enhance service delivery and resource efficiency. Dissemination is a service offered by WSN that uses radio transmission and over‐the‐air programming for updating the deployed sensor nodes through online. The centralized data dissemination methods are replaced by the distributed approaches because they affect the drawbacks of a single point of failure, no scalability, and insecurity. Therefore, an Energy Efficient Protocol for Data Dissemination in Wireless Sensor network‐enabled IoT using Domain‐Adaptive Message Passing Graph Neural Network (EEP‐WSN‐IoT‐DMPGNN) is proposed in this paper. The nodes are formed as clusters utilizing the Deep Fuzzy Curriculum Clustering (DFCC) technique that rewards nodes belonging to a given cluster. By using the Crayfish Optimization Algorithm (COA), the Cluster Head (CH) selection optimally chose the ideal CH and satisfies the multiple objective functions, such as energy, delay, traffic density, and distance. Afterward, domain‐adaptive Message Passing Graph Neural Network (DMPGNN) based routing protocol is developed, the input given to the routing protocol includes a sink, action history, future node, and maximum‐distance node, which attains enhanced data transfer in the chosen path. The proposed technique attains a lower no. of dead nodes, lower energy consumption, and higher Network Lifetime while analyzed with existing techniques, such as routing technique depending on deep learning for effectual data transmission in 5G WSN communication (DL‐RPDT‐WSN), Reinforcement‐Learning base energy effectual optimized routing protocol in WSN (RL‐EERP‐WSN), and Energy‐efficient intellectual routing method for IoT‐enabled WSN (EIR‐IoT‐WSN), respectively.

Barriers and facilitators in the implementation of youth and young adult models of mental health care.

It is increasingly recognised that traditional models of mental health (MH) care, with a service transition at age 18 years, may not reflect best practice. The literature supports a move towards youth and young adult focused models of MH care, for young people up to the age of 25, which specifically cater to the unique psychosocial and developmental needs of this population. This service evaluation aimed to explore the facilitators and barriers to the implementation of youth models of MH care across England (UK). Six services participated in separate focus groups pertaining to their experience of implementing youth models of MH care. The interview guide for the focus groups was informed by the Consolidated Framework for Implementation Research (CFIR) and explored barriers and facilitators to implementation and sustainment. The focus groups were recorded, transcribed verbatim and analysed thematically. Seven key themes relevant to the implementation of youth models of MH care were identified: a clear rationale for doing things differently, for young people by young people, "building those relationships is key", service identity development, resource and infrastructure, leadership at multiple levels, and valuing and developing staff. The findings suggest effective communication and leadership, co-production and cross system collaboration contribute to successful implementation of youth models of MH care. The findings will be of interest to those involved in informing and supporting successful implementation and delivery of youth models of mental health care at local and national levels.

Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China

Improving access to HIV/AIDS healthcare services is of great concern to government and policymakers striving to strengthen overall public health. How to reasonably allocate HIV/AIDS healthcare resources and maximize the equality of access to healthcare services across subdistrict areas has become an urgent problem to be solved. However, there is limited research on this topic in China. It is necessary to evaluate spatial accessibility to improve the accessibility and equity of HIV/AIDS healthcare services. In this study, the improved multi-modal two-step floating catchment area (2SFCA) and inverted 2SFCA (i2SFCA) methods are used to measure the spatial accessibility of HIV/AIDS healthcare services and the crowdedness of the healthcare sites in Shandong Province, China. Then, the theoretical supply and the optimal spatial distribution of resources are calculated and visualized by minimizing the accessibility gaps between demand locations. This study showed that the spatial accessibility of HIV/AIDS service resources in Shandong Province was concentrated and unevenly distributed, and the accessibility scores in the marginal areas of prefecture-level cities were significantly lower than those in other areas. Regions with a large number of doctors had significantly higher levels of spatial accessibility. The ART accessibility scores in the southwest of Shandong Province were higher than those in other regions. As the travel friction coefficient increased, the accessibility scores formed an approximately circular cluster distribution centered on the healthcare sites in geographical distribution. More ART drugs needed to be supplied in marginal areas and more doctors were needed to work on HIV/AIDS in urban areas to address the spatial distribution imbalance of HIV/AIDS healthcare services. This study profoundly analyzed the spatial accessibility of HIV/AIDS healthcare services and provided essential references for decision-makers. In addition, it gives a significant exploration for achieving the goal of equal access to HIV/AIDS healthcare services in the future.

Cost-effectiveness of empagliflozin as add-on to standard of care for chronic kidney disease management in the United Kingdom

Objective The sodium-glucose co-transporter-2 inhibitor empagliflozin was approved for treatment of adults with chronic kidney disease (CKD) on the basis of its demonstrated ability to slow CKD progression and reduce the risk of cardiovascular death. This analysis was performed to assess the cost-effectiveness of empagliflozin plus standard of care (SoC) vs SoC alone in the treatment of CKD in the UK. Methods A comprehensive, patient-level CKD progression model that simulates the evolution of risk factors for disease progression based on CKD-specific equations and clinical data was used to project a broad range of CKD-related complications. Patient baseline characteristics, distribution across Kidney Disease Improving Global Outcomes (KDIGO) health states, and changes in estimated glomerular filtration rate (eGFR), urine albumin-creatinine ratio (uACR), and other parameters while on treatment were derived from the EMPA-KIDNEY trial. UK cost and utilities/disutilities were sourced from the literature. Univariate and probabilistic sensitivity analyses were conducted. Annual discounting of 3.5% was applied on costs and outcomes. Results Over a 50-year horizon, SoC resulted in per-patient costs, life years, and QALYs of £95,930, 8.55, and 6.28, respectively. Empagliflozin plus SoC resulted in an incremental gain in life years (+1.04) and QALYs (+0.84), while decreasing per-patient costs by £6,019. Empagliflozin was more effective and less costly (dominant) with a net monetary benefit of £22,849 at the willingness-to-pay threshold of £20,000. Although treatment cost was higher for empagliflozin, this was more than offset by savings in kidney replacement therapy. Empagliflozin remained highly cost-effective in patients with and without diabetes, and across scenario and sensitivity analyses. Limitations This analysis is limited by reliance on short-term clinical trial data and by uncertainties in modelling CKD progression. Conclusions Empagliflozin as an add-on to SoC for treatment of adults with CKD represents cost-effective use of UK National Health Service (NHS) resources.

Federated learning in smart home: A dynamic contract-based incentive approach with task preferences

Federated Learning (FL) is a new type of distributed machine learning paradigm aimed at addressing data privacy and security issues in the Internet of Things (IoT) context. In the training process of federated learning model of smart home, data owners need to constantly update cached data, which lead to resources consumption and service latency. Meanwhile, the update cost of the data owners will change with the passage of time when the model owner requests data update. Therefore, this paper first puts forward an incentive scheme based on two-period dynamic contract theory under the information asymmetry. The scheme can balance the weighted preference of the model owner for age of information (AoI) and service latency, as well as encourage more data owners to participate in model training to increase the utility of model owner. Then we formally prove the feasibility of the proposed dynamic contract, which satisfies the constraints of individual rationality and intertemporal incentive compatibility. The experimental results on MNIST dataset show that the accuracy of the proposed dynamic contract is improved by at least 4% compared with the existing contracts. Additionally, compared with traditional contract and consistent pricing strategy, the model owner obtains more profit from the proposed contract.

Technical efficiency and its convergence among village clinics in rural China: evidence from Shanxi Province.

Village clinics (VCs) are the foundation of the three-tiered health service system in China, delivering basic and routine outpatient services to citizens in rural China. VC technical efficiency and its convergence play a critical role in policy decisions regarding the distribution of health service resources in rural China. This study measured VC technical efficiency (using the slacks-based measure model), its convergence (using the convergence model), and the factors that influence the convergence in Shanxi Province, China. Data were obtained from the Shanxi Rural Health Institute 2014-2018 Health Statistics Report, which involved 3,543 VCs. The results showed that VC technical efficiency was low and differed by region. There was no α convergence in VC technical efficiency, but evidence of β convergence was found in Shanxi. The main factors that influence convergence were the building area of each VC (BA), proportion of government subsidies (PGS), and ratio of total expenditure to total income of each VC (RTETI). The government should increase investments in VCs and improve VC technical efficiency. Meanwhile, the government should be aware of and take measures to curb the inequity in VC technical efficiency among different regions and take suitable measures to curb this disparity.