Efficiency measurement and spatial spillover effect of provincial health systems in China: Based on the two-stage network DEA model

Yang, Yuping; Zhang, Liqin; Zhang, Xiaoyan; Yang, Mengting; Zou, Wenjie

doi:10.3389/fpubh.2022.952975

Cited by 14 publications

(15 citation statements)

References 80 publications

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“…However, this aggregation characteristic is significantly weakening, which also reflects the improvement of the fairness of development. This conclusion is consistent with the research results of Yang [12] and Diedd [29] and confirms the Chinese government's assessment of the state of primary medical health development in the central and western regions, that the development of primary medical health in central and western regions is insufficient and the problem of imbalance needs to be addressed.…”

Section: Conclusion and Discussionsupporting

confidence: 89%

“…Previous articles on the supply efficiency of health service have mostly focused on the economic impact of human resource efficiency [10] and the impact of human resource efficiency and medical institutions [11]. Researchers have mostly measured the supply efficiency of Chinese health services from a national perspective [12] or evaluated the systemic level of health care in China [13]. Therefore, in the context of Chinese policies, existing gaps, and cutting-edge research, what is the level of supply efficiency of primary health services in central and western China?…”

Section: Introductionmentioning

confidence: 99%

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Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China

Zhu

et al. 2023

IJERPH

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China has established a comprehensive primary medical health service system, but the development of primary medical health services in the central and western regions is still unbalanced and insufficient. Based on data from 2010 to 2019, this paper constructs a super efficiency Slack-Based Measure model to calculate the supply efficiency of primary medical health services in 20 provinces and cities in central and western China. Using Kernel density estimation and Markov chain analysis, this paper further analyzes the spatial-temporal evolution of the supply efficiency of primary medical health services in central and western China, and also predicts the future development distribution through the limiting distribution of Markov chain to provide a theoretical basis for promoting the sinking of high-quality medical resources to the primary level. The results show that firstly, during the observation period, the center of the Kernel density curve moves to the left, and the main peak value decreases continuously. The main diagonal elements of the traditional Markov transition probability matrix are 0.7872, 0.5172, 0.8353, and 0.7368 respectively, which are significantly larger than other elements. Secondly, when adjacent to low state and high state, it will develop into convergence distributions of 0.7251 and 0.8243. The supply efficiency of primary medical health services in central and western China has the characteristics of high (Ningxia) and low (Shaanxi) aggregation respectively, but the aggregation trend is weakened. Thirdly, the supply efficiency of health services has the stability of keeping its own state unchanged, but the transition of state can still occur. The long-term development of the current trend cannot break the distribution characteristics of the high and low clusters, the efficiency will show a downward trend in the next 10–20 years, and still the problem of uneven long-term development emerges.

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Section: Conclusion and Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China

Zhu

et al. 2023

IJERPH

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“…This differentiation may be the protective measures in the GULF region which help them to consume lower financial budget on their residents. Some of the studies also validate similar nexus of energy consumption and health expenditure (Yang, Zhang, Zhang, Yang, & Zou, 2022;. Our results predict that CO2 emission significantly contribute to health expenditure in GULF and North American regions, which implies that CO2 emission threatens the human health and create diseases due to which household as well as government has to consume more budget to deal with rising health issues that emerges due to the increasing CO2 emission.…”

Section: Empirical Analysis and Discussionsupporting

confidence: 77%

Re-visiting the Nexus Between Energy Consumption, Environmental Quality and Health Expenditure in Gulf and North American Regions

Zeeshan,

Rehman,

Ullah

2023

Preprint

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The dynamic relationship between energy consumption, environmental quality and health expenditures have been explored at country as well as regional level, but research on the comparison of regions in the paradox of these variables of interest is rare in the body of knowledge. Therefore, this paper attempts to investigate the relationship between energy consumption, environmental quality and health expenditure as the relationship of these variables in the context of GULF and North American regions is center of attention in the research community due to their emerging landscape. We use the data of seven GULF countries and the same number of countries from North American regions using Penal-ARDL and PMG-ARDL for the period 1990 to 2019. Our results demonstrate that energy consumption increases CO2 emission in GULF as well as North American region, but the effect of energy consumption on the health expenditure in GULF region is statistically insignificant which may be due to protective initiatives in GULF region. Whilst, CO2 emissions is contributing to more health expenditures in both regions, indicating that more CO2 emissions threatening the health quality in both regions. Our results are very pivotal to the policy makers in these regions for their strategic landscape to make frameworks that could be effective to obtain health quality and environmental milestones.

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“…The service efficiency of PHCIs is one of the most studied elements. In empirical studies, data envelopment analysis (DEA), is widely applied by scholars to analyze the efficiency of such multi-input, multi-output organizations as healthcare institutions ( 15 – 18 ). DEA is a non-parametric method that analyzes the efficiency of PHCIs from the observed data to specify the shape of the production frontier and therefore has no restrictions on the form of the efficient frontier ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Analyzing the efficiency of Chinese primary healthcare institutions using the Malmquist-DEA approach: Evidence from urban and rural areas

Zhou

Peng

Chang

et al. 2023

Front. Public Health

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BackgroundChina has been increasing the investment in Primary Health Care Institutions (PHCIs) since the launch of the New Health Care System Reform in 2009. It is a crucial concern whether the PHCIs can meet residents' need both in urban and rural with the limited government finance, especially encountering the challenge of the COVID-19. This study aimed to reveal the trend of the primary health service efficiency in the past decade, compare the urban-rural differences, and explore relevant factors.MethodsDEA and Malmquist models were applied to calculate the health service efficiency of PHCIs among 28 provinces in China, with the input variables including the number of institutions, number of beds, number of health technicians, and the outputs variables including the number of outpatients and emergency visits, number of discharged patients. And the Tobit model was used to analyze the factors on the efficiency in urban and rural. A sensitivity analysis for model validations was also carried out.ResultsThe average technical efficiency (TE) of urban PHCIs fluctuated from 63.3% to 67.1%, which was lower than that in rural (75.8–82.2%) from 2009 to 2019. In terms of dynamic efficiency, the urban PHCIs performed better than the rural, and the trends in the total factor productivity change were associated with favorable technology advancement. The population density and dependency ratio were the key factors on TE in both of the urban and rural PHCIs, and these two factors were positively correlated to TE. In terms of TE, it was negatively correlated with the proportion of total health expenditure as a percentage of GDP in urban PHCIs, while in rural it was positively correlated with the urbanization rate and negatively correlated with GDP per capita. Besides, the tests of Mann–Whitney U, and Kruskal–Wallis H indicated the internal validity and robustness of the chosen DEA and Malmquist models.ConclusionsIt needs to reduce the health resource wastes and increase service provision in urban PHCIs. Meanwhile, it is necessary to strengthen medical technology and gaining greater efficiency in rural PHCIs by technology renovation.

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Efficiency measurement and spatial spillover effect of provincial health systems in China: Based on the two-stage network DEA model

Cited by 14 publications

References 80 publications

Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China

Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China

Re-visiting the Nexus Between Energy Consumption, Environmental Quality and Health Expenditure in Gulf and North American Regions

Analyzing the efficiency of Chinese primary healthcare institutions using the Malmquist-DEA approach: Evidence from urban and rural areas

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