Distribution and determinants of hospital efficiency and relative productivity in county-level hospitals in rural China: an observational study

Abstract

BackgroundCataract surgery is very important to prevent blindness, but its productivity and efficiency in China are unknown. Our study aimed to evaluate the geographical distribution of cataract surgeons and prospectively identify the factors associated with the increased productivity in cataract surgery and efficiency in outpatient ophthalmic services in rural Chinese hospitals.MethodsData were prospectively collated from various hospital datasets and the census registered by the geographical unit county. Prior to mapping, the geographical location data of counties were cross-linked with the equivalent ophthalmologist and service output data to create categories and map multiple data attributes. Descriptive statistical analyses were performed to characterise the data stratified by county. Linear regression analyses were used to explore the factors associated with the increased productivity/efficiency.ResultsThe ophthalmologists, surgical productivity of ophthalmologists and outpatient efficacy of ophthalmologists significantly varied across counties. During the period between 2016 and 2018, the median (IQR) change in surgical productivity of and outpatient efficacy of ophthalmologists were 31.627 (−3.33 to 29.94) and 118.08 (−132.30 to 740.89). In the simple regression analysis for predictors of a high productivity change, only the increased number of phaco machine had statistical significance (p=0.003). In addition, only the gross domestic product per capita in 2016 was associated with an increased improvement in efficiency of outpatient services (p=0.008).ConclusionsThis study demonstrated that the ophthalmologist productivity and the efficiency of outpatient services were unequally geographically distributed, and their predictors were identified. Further studies to elucidate the extent of the problem and improve the health service delivery models are required.

Geographic distribution of ophthalmologist in East Java 2023

“…Factors such as phacoemulsification devices, socioeconomic status, and GDP per capita likely played a role in the growth of rural cataract surgery capabilities. The study could serve as a useful reference for government investment aimed at expanding surgical procedures and outpatient services (Zhong et al, 2021).…”

The Efficiency Evaluation of Municipal-Level Traditional Chinese Medicine Hospitals Using Data Envelopment Analysis After the Implementation of Hierarchical Medical Treatment Policy in Gansu Province, China

“…This research allocation affects the health level of residents and plays an important role in the sustainable development of medical and health services. [8][9][10][11][12][13][14][15][16] Similarly, research on the factors affecting hospital efficiency and improvement strategies has become the focus of analysis and discussion. It encourages hospitals to continue to work towards operational efficiency.…”