Evaluating the efficiency of primary health care institutions in China: an improved three-stage data envelopment analysis approach

Author:

Su Wanmin,Hou Yatian,Huang Mengge,Xu Jiamian,Du Qingfeng,Wang Peixi

Abstract

Abstract Background Primary health care (PHC) institutions are key to realizing the main functions of the health care system. Since the new health care reform in 2009, the Chinese government has invested heavily in PHC institutions and launched favorable initiatives to improve the efficiency of such institutions. This study is designed to gauge the efficiency of PHC institutions by using 2012–2020 panel data covering 31 provinces in China. Methods This study applied an improved three-stage data envelopment analysis (DEA) model to evaluate the efficiency of PHC institutions in China. Unlike the traditional three-stage DEA model, the input-oriented global super-efficiency slack-based measurement (SBM) DEA model is used to calculate the efficiency in the first and third stages of the improved three-stage DEA model, which not only allows the effects of environmental factors and random noise to be taken into account but also deal with the problem of slack, super-efficiency and the comparability of interperiod efficiency values throughout the efficiency measurement. Results The results show that the efficiency of PHC institutions has been overestimated due to the impact of external environmental factors and random noise. From 2012 to 2020, the efficiency of PHC institutions displayed a downward trend. Moreover, there are significant differences in the efficiency of PHC institutions between regions, with the lowest efficiency being found in the northeast region. The efficiency of PHC institutions is significantly affected by residents’ annual average income, per capita GDP, population density, the percentage of the population aged 0–14, the percentage of the population aged 65 and older, the number of people with a college education and above per 100,000 residents, and the proportion of the urban population. Conclusions Substantial investment in PHC institutions has not led to the expected efficiency gains. Therefore, more effective measures should be taken to improve the efficiency of PHC institutions in China based on local conditions. This study provides a new analytical approach to calculating the efficiency of PHC institutions, and this approach can be applied to efficiency evaluation either in other fields or in other countries.

Funder

the Foshan Chinese Medicine Field First Pilot Science and Technology Research Special Project

the National Key Research and Development Program

Publisher

Springer Science and Business Media LLC

Subject

Health Policy

Reference78 articles.

1. Yan C, Liao H, Ma Y, Wang J. The impact of health care reform since 2009 on the efficiency of primary health services: a provincial panel data study in China. Front Public Health. 2021;9:735654.

2. The World Bank and World Health Organization. Healthy China: Deepening Health Reform in China. Building High-Quality and Value-Based Service Delivery. Peking: China Finance and Economy Media Group; 2018. p. 39.

3. Planning, Development, and Information Technology Division: Statistical bulletin on the development of health care in China in 2021. 2022. http://www.nhc.gov.cn/guihuaxxs/s3586s/202207/51b55216c2154332a660157abf28b09d.shtml Accessed 3 Mar 2023.

4. National Health Commission of the People's Republic of China. China Health Care Statistics Yearbook. Peking: Peking Union Medical College Press; 2021. p. 217–33.

5. Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, et al. Quality of primary health care in China: challenges and recommendations. Lancet. 2020;395:1802–12.

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3