Background: Traditional Chinese Medicine (TCM) Hospitals are the dominant agents to provide TCM services in China. How to improve the productivity and efficiency of TCM hospitals is quite pivotal for the hospital managers and policy-makers to realize the optimal use of TCM resources. The purpose of this study was to estimate the productivity and efficiency of TCM hospitals with the Bootstrap-Malmquist-Data Envelopment Analysis (DEA) from 2009 to 2016 to provide empirical evidence for hospital managers and policy-makers to improve the management and quality of TCM service.Methods: The data of the individual tertiary public TCM hospitals were collected from official Yearbooks of Traditional Chinese Medicine of China (2010-2017). Bootstrap-Malmquist-DEA was employed to measure the productivity and efficiency of the TCM hospitals from 2009 to 2016. SPSS 23.0 version statistical software was used to conduct the descriptive analysis of the input and output indicators. R 3.2.1 version statistical software was applied to calculate the productivity and efficiency of the TCM hospitals with FEAR package. The statistical significant was set at P < 0.05.Results: The annual average growth rates for each input and output indicator were 6.61% (health professionals), 8.15% (actual open beds), 7.08% (outpatients and inpatients) and 12.50% (discharged patients) respectively from 2009 to 2016. Except the TFPC between 2014 and 2015, more than half of the TCM hospitals had TFPC scores over 1.000, indicating increased productivity. The overall annual geo-means of the scores of the TFPC and its decomposition index were 1.0379 (TFPC), 1.0167 (TEC), 1.0209 (TC), 1.0212 (PTEC), and 0.9955 (SEC) respectively from 2009 to 2016.Conclusions: The overall annual rate of the total factor productivity of the tertiary public TCM hospitals was slightly increased. The technological progress was the main driver to improve the total factor productivity. The decreased TE was more affected by the decreased SE. The TCM hospitals need to pay attention to the development and innovation of the TCM technology, thereby improving the competitiveness. The TCM hospitals managers should pursuit the high quality, high efficiency and low cost of the TCM medical services.

No abstract