The Technical Efficiency of Community Health Service Centers in Wuhan, China: Estimation and Policy Implications

Liu, Xinliang; Wang, Quan; Barsanti, Sara; Yang, Wei; Dong, Shaoming; Li, Hao

doi:10.1177/0046958018812972

Cited by 7 publications

(14 citation statements)

References 32 publications

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“…High productivity and e ciency of the TCM hospitals is highly related to the rational use of health resources (14). The rational use of health resources can be up to the well-structured health professionals (17). Even though this study showed that the number of health professionals was increasing yearly, it could not infer whether the structure of the health professionals was appropriate, especially the ratio between the western clinical doctors/pharmacists and the TCM doctors/pharmacists.…”

Section: Discussionmentioning

confidence: 75%

“…According to a systematic review on the relative e ciency research of Chinese hospitals with DEA models conducted by Dong & Li (9), they have suggested that the technical e ciency and allocative e ciency were always misunderstood by misuse of combination of monetary and volume indicators. The review and a previous study published by our research team (17) also have mentioned that price information of the indicators is much more di cult than the volume information to be accessed in Chinese hospitals. Therefore, based on the frequency of input and output indicators used most in current studies and the feasibility of data, in this study, the input indicators were the number of health professionals and the number of actual open beds, while the number of outpatients and inpatients and the number of discharged patients were selected as the output indicators.…”

Section: Input and Output Indicators Selectionmentioning

confidence: 94%

“…Considering the productivity and e ciency of all decision making units (DMUs), that is, all TCM hospitals are actually affected by the environmental and random factors (15)(16)(17)(18), the Bootstrap method was introduced to solve this problem (21)(22)(23). Its basic idea is to simulate the data-generating process (DGP) by repeating sample selection, thereby bias-corrected productivity and e ciency scores with CIs being generated.…”

Section: Tfpc = Tec × Tc= (Ptec × Sec) × Tcmentioning

confidence: 99%

“…In our previous study, we applied the Bootstrap-DEA model to estimate the e ciency of other kinds of health institutions, like community health service centers (17), public general hospitals (18), and township hospitals (19). The purpose of this study was to measure the productivity and e ciency of the TCM hospitals with the Bootstrap-Malmquist-DEA model from 2009 to 2016 to provide empirical evidence for hospital managers and policy-makers to improve the management and quality of TCM medical services.…”

Section: Introductionmentioning

confidence: 99%

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Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals From 2009 to 2016: A Bootstrap-Data Envelopment Analysis

Liu

Chen²,

et al. 2020

Preprint

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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.

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Section: Discussionmentioning

confidence: 75%

Section: Input and Output Indicators Selectionmentioning

confidence: 94%

Section: Tfpc = Tec × Tc= (Ptec × Sec) × Tcmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals From 2009 to 2016: A Bootstrap-Data Envelopment Analysis

Liu

Chen²,

et al. 2020

Preprint

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“…In recent years, efficiency of public hospitals has become a concern for policymakers and researchers dealing with health expenditure growth in both developed and developing countries [ 1 , 2 , 3 , 4 , 5 , 6 ]. In China, this issue has long drawn scholars’ attention, and several articles have been published [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Generally, Chinese public hospitals are classified according to three standards, namely service capacity (i.e., primary, secondary, and tertiary hospitals), service items (i.e., general and specialized hospitals), and administrative subordination by government agencies in accordance with regulations.…”

Section: Introductionmentioning

confidence: 99%

Efficiency Comparison of Public Hospitals under Different Administrative Affiliations in China: A Pilot City Case

et al. 2021

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This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.

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The Evolving Hospital Market in China After the 2009 Healthcare Reform

Jiang

Pan

2020

INQUIRY

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Since the initiation of national healthcare reform in 2009, China’s hospital market has witnessed significant change. To provide a brief description about its evolving process, China Health Statistical Yearbook data and Sichuan administrative data from 2009 to 2017 were used in this article. An overall upward trend of hospital delivery capacity was found in this study, which increased from 3.12 million beds and 1.09 million doctors in 2009 to 6.12 million and 1.80 million in 2017, respectively, while the primary healthcare institutions presented fairly slow development pace. Growing proportion of medical resources and patients gathered in hospitals, especially tertiary hospitals. While private hospitals demonstrated an increasingly important role in hospital market with growing share of capacity and service, their average capacity, especially the human resource, was found to be much lower than that of public hospitals and the gaps are still widening. The competition among hospitals grouped by homogeneous ownership types has predominated the increasingly intensified hospital market competition in China. In order to adapt to the raising demand of health care in China, it is highly recommended that strategies forged at governmental levels be focused on primary care promotion, guiding the development of private hospitals as well as on promoting orderly competition in the hospital market.

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The Technical Efficiency of Community Health Service Centers in Wuhan, China: Estimation and Policy Implications

Cited by 7 publications

References 32 publications

Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals From 2009 to 2016: A Bootstrap-Data Envelopment Analysis

Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals From 2009 to 2016: A Bootstrap-Data Envelopment Analysis

Efficiency Comparison of Public Hospitals under Different Administrative Affiliations in China: A Pilot City Case

The Evolving Hospital Market in China After the 2009 Healthcare Reform

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