Efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis

Zhaohui Cheng · Miao Cai · Hongbing Tao · Zhifei He · Xiaojun Lin · Haifeng Lin +1 more

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Efficiency Analysis Using DEA Healthcare Quality and Management Healthcare Systems and Reforms

Abstract

OBJECTIVE: Township hospitals (THs) are important components of the three-tier rural healthcare system of China. However, the efficiency and productivity of THs have been questioned since the healthcare reform was implemented in 2009. The objective of this study is to analyse the efficiency and productivity changes in THs before and after the reform process. SETTING AND PARTICIPANTS: A total of 48 sample THs were selected from the Xiaogan Prefecture in Hubei Province from 2008 to 2014. OUTCOME MEASURES: First, bootstrapping data envelopment analysis (DEA) was performed to estimate the technical efficiency (TE), pure technical efficiency (PTE) and scale efficiency (SE) of the sample THs during the period. Second, the bootstrapping Malmquist productivity index was used to calculate the productivity changes over time. RESULTS: The average TE, PTE and SE of the sample THs over the 7-year period were 0.5147, 0.6373 and 0.7080, respectively. The average TE and PTE increased from 2008 to 2012 but declined considerably after 2012. In general, the sample THs experienced a negative shift in productivity from 2008 to 2014. The negative change was 2.14%, which was attributed to a 23.89% decrease in technological changes (TC). The sample THs experienced a positive productivity shift from 2008 to 2012 but experienced deterioration from 2012 to 2014. CONCLUSIONS: There was considerable space for TE improvement in the sample THs since the average TE was relatively low. From 2008 to 2014, the sample THs experienced a decrease in productivity, and the adverse alteration in TC should be emphasised. In the context of healthcare reform, the factors that influence TE and productivity of THs are complex. Results suggest that numerous quantitative and qualitative studies are necessary to explore the reasons for the changes in TE and productivity.

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References

1978Measuring the efficiency of decision making units 1984Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis 1957The Measurement of Productive Efficiency 1988China statistical yearbook 1999Data Envelopment Analysis: A Comprehensive Text with Models, Applications, References and DEA-Solver Software 1982The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity 2005Estimation and inference in two-stage, semi-parametric models of production processes 1994Data Envelopment Analysis: Theory, Methodology, and Applications

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