Evaluation of resource utilization efficiency in obstetrics and gynecology units in China: A three‐stage data envelopment analysis of the Shanxi province

Lü, Wei; Zhang, Tao; Ni, Ziling; Tao, Hongbing

doi:10.1002/hpm.2908

Cited by 10 publications

(6 citation statements)

References 33 publications

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“…Some studies also adopt the Malmquist productivity index to decompose healthcare efficiency ( 15 , 20 ). Meanwhile, a three-stage DEA model is employed in the empirical analysis ( 21 , 22 ). Moreover, more and more scholars are no longer limited to using the DEA model alone, they tend to combine the DEA model with other models to evaluate the health system efficiency.…”

Section: Literature Reviewmentioning

confidence: 99%

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

Yang

Zhang

et al. 2022

Front. Public Health

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The effectiveness of a health care system is an important factor for improving people's health and quality of life. The purpose of this research is to analyze the efficiency and spatial spillover effects of provincial health systems in China using panel data from 2009 to 2020. We employ the two-stage network DEA model to evaluate their efficiencies and use a spatial econometric model for empirical estimation. The results suggest that the overall efficiency, resource allocation efficiency, and service operation efficiency of health systems in different regions of China generally have fluctuating upward trends, with large differences in efficiency among the various regions. Further analysis reveals that the efficiency of China's health system has a significant spatial spillover effect. The level of economic development, fiscal decentralization and old-age dependency ratio are important factors affecting the health system efficiency. Our findings help to identify the efficiency and internal operating mechanisms of China's health system at different stages, and are expected to contribute to policymakers' efforts to build a high-quality health service system.

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Section: Literature Reviewmentioning

confidence: 99%

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

Yang

Zhang

et al. 2022

Front. Public Health

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“…Third, the three-stage DEA approach is used, integrating the conventional DEA model with stochastic frontier analysis (SFA) to adjust for the effects of environmental variables and statistical noise on efficiency values. Resource utilization efficiency in obstetrics and gynecology units was studied with a three-stage DEA method, and the technical efficiency and scale efficiency values of units were 0.48 and 0.54, respectively [ 35 ]. By using the three-stage DEA method, the technical efficiency of Chinese regional public hospitals was measured, and the average efficiency was found to improve from 0.927 to 0.981 during the period 2011–2018 [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Fan

et al. 2022

Int J Equity Health

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Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation. Methods Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.

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“… 7 9 12 19–22 Input variables usually include labour and capital. 42 In our study, the numbers of registered doctors and registered nurses were used to represent the elements of human resources as input variables. Beds and equipment valued above 10 000 yuan were used as capital elements.…”

Section: Results and Analysismentioning

confidence: 99%

Study of the medical service efficiency of county-level public general hospitals based on medical quality constraints: a cross-sectional study

Guo

Huang

et al. 2023

BMJ Open

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ObjectivesSince the new medical reform in 2009, county-level hospitals in China have achieved rapid development, but health resource waste and shortage issues still exist.DesignWe applied the meta-frontier and slacks-based measurement-undesirable data envelopment analysis model to measure the medical service efficiency with or without medical quality constraints of the county-level public general hospitals (CPGHs). The assessment includes four inputs, three desirable outputs and one undesirable output. We conducted the assessment via Max-DEA V.8.19 software. Moreover, we analyse the factors affecting CPGHs’ medical service efficiency based on the fractional response model.SettingA total of 77 sample CPGHs were selected from Shanxi province in China from 2013 to 2018.ResultsThe results of this study showed that the efficiency level of county-level public hospitals in Shanxi Province is relatively low overall (the mean value of efficiency is 0.61 without quality constraints and 0.63 under quality constraints). This showed that ignoring medical quality constraints will result in lower efficiency and lower health resource usage for high medical quality hospitals. The medical service efficiency of CPGHs differs greatly among different regions. Under the meta-frontier, the hospitals in the central region had the highest efficiency (efficiency score 0.70), followed by those in the south (efficiency score 0.63) and the hospitals in the north had the lowest efficiency (efficiency score 0.54). Factors that have larger impacts on the service efficiency of county public hospitals are the average length of hospital stay, per capita disposable income and financial subsidy income.ConclusionsTo improve CPGHs’ medical service efficiency, the government should increase investment in the northern region, and hospitals should improve the management level and allocate human resources rationally.

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Evaluation of resource utilization efficiency in obstetrics and gynecology units in China: A three‐stage data envelopment analysis of the Shanxi province

Cited by 10 publications

References 33 publications

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

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

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Study of the medical service efficiency of county-level public general hospitals based on medical quality constraints: a cross-sectional study

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