Top

Journal of Public Health

Published in:

01-04-2020 | Original Article

Evaluation and analysis of hospital efficiency in China based on macro- and micro-level analyses

Authors: Lin Zhao, Lan Wang, Shu Li, Yao Zhang

Published in: Journal of Public Health | Issue 2/2020

Abstract

Aim

To explore the efficiency of Chinese hospitals at the macro and micro levels during 2011–2015.

Subjects and methods

A national evaluation of hospital efficiency in China (macro level) was carried out based on hospital data from 31 provinces. Furthermore, Tianjin was selected as a field research site (micro level). Dynamic and static evaluations were conducted based on data envelopment analysis (DEA). Data were collected from the Health Statistical Yearbook and governmental departments.

Results

Hospitals were DEA-effective or weakly effective in 20 provinces. Hospitals in 64.5% of the provinces exhibited technical efficiency (TE), whereas hospitals in 11 provinces had investment resources that had not been fully utilized (TE < 1). In addition, 20 provinces had inefficient scale efficiency (SE). The Malmquist productivity index (MPI) during the periods 2011–2012, 2014–2015, and 2011–2015 was ≥ 1. Ten tertiary hospitals and six secondary hospitals were overall effective (OE), but six tertiary hospitals and ten secondary hospitals were not fully effective at the micro level.

Conclusions

Hospital efficiency in China improved during 2011–2015, but with geographical differences. Half of the hospitals in Tianjin were relatively inefficient but its tertiary hospitals had a higher quality of care.

Available only for authorised users

Barber SL, Borowitz M, Bekedam H, Ma J (2014) The hospital of the future in China: China’s reform of public hospitals and trends from industrialized countries. Health Policy Plan 29:367–378CrossRef

Chen Y, Banta D, Tang Z (2009) Health technology assessment development in China. Int J Technol Assess Health Care 25(Suppl 1):202–209CrossRef

Chen M, Chen W, Zhao Y (2012) New evidence on financing equity in China’s health care reform—a case study on Gansu province, China. BMC Health Serv Res 12:466CrossRef

Cheng Z, Cai M, Tao H, He Z, Lin X, Lin H, Zuo Y (2016) Efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis. BMJ Open 6:e011911CrossRef

Dong H, Duan S, Bogg L, Wu Y, You H, Chen J, Ye X, Seccombe K, Yu H (2016) The impact of expanded health system reform on governmental contributions and individual copayments in the new Chinese rural cooperative medical system. Int J Health Plann Manag 31:36–48CrossRef

Feng XL, Martinez-Alvarez M, Zhong J, Xu J, Yuan B, Meng Q, Balabanova D (2017) Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949–1980). Int J Equity Health 16:49CrossRef

Flokou A, Kontodimopoulos N, Niakas D (2011) Employing post-DEA cross-evaluation and cluster analysis in a sample of Greek NHS hospitals. J Med Syst 35:1001–1014CrossRef

Fu H, Li L, Li M, Yang C, Hsiao W (2017) An evaluation of systemic reforms of public hospitals: the Sanming model in China. Health Policy Plan 32:1135–1145CrossRef

Gai RY, Zhou CC, Xu LZ, Zhu M, Wang XZ, Li SX, Zheng WG, Song PP, Yang XL, Fang LY, Zhen YC, Tang W (2010) Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005. Biosci Trends 4:218–224PubMed

Hofmarcher MM, Paterson I, Riedel M (2002) Measuring hospital efficiency in Austria—a DEA approach. Health Care Manag Sci 5:7–14CrossRef

Jia T, Yuan H (2017) The application of DEA (data envelopment analysis) window analysis in the assessment of influence on operational efficiencies after the establishment of branched hospitals. BMC Health Serv Res 17:265CrossRef

Jiang S, Wu WM, Fang P (2016) Evaluating the effectiveness of public hospital reform from the perspective of efficiency and quality in Guangxi, China. Springerplus 5:1922CrossRef

Li L, Zhang Z, Sun Z, Zhou H, Liu X, Li H, Fan L, Coyte PC (2014) Relationships between actual and desired workplace characteristics and job satisfaction for community health workers in China: a cross-sectional study. BMC Fam Pract 15:180CrossRef

Li C, Sun M, Shen JJ, Cochran CR, Li X, Hao M (2016) Evaluation on the efficiencies of county-level Centers for Disease Control and Prevention in China: results from a national survey. Tropical Med Int Health 21:1106–1114CrossRef

Lin L, Huo MF, Sun RH, Wang YX, Zhang HP, Wang ZJ, Fan F (2014) Performance evaluation of scientific research projects by DEA. Chin J Med Sci Res Manag 6:630–635

Long Q, Xu L, Bekedam H, Tang S (2013) Changes in health expenditures in China in 2000s: has the health system reform improved affordability. Int J Equity Health 12:40CrossRef

Lu F, Qiang DF (2018) Research progress on the collaboration system among hospitals and community health service institutions under the background of hierarchical medical services. Chin Health Serv Manag 7:494–495

Ma J, Lu M, Quan H (2008) From a national, centrally planned health system to a system based on the market: lessons from China. Health Aff (Millwood) 27:937–948CrossRef

Raven J, van den Broek N, Tao F, Kun H, Tolhurst R (2015) The quality of childbirth care in China: women’s voices: a qualitative study. BMC Pregnancy Childbirth 15:113CrossRef

Renner A, Kirigia JM, Zere EA, Barry SP, Kirigia DG, Kamara C, Muthuri LH (2005) Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application. BMC Health Serv Res 5:77CrossRef

Si X, Li J, Bi X, Wu L, Wu X (2015) Clinical evaluation of high-volume hemofiltration with hemoperfusion followed by intermittent hemodialysis in the treatment of acute wasp stings complicated by multiple organ dysfunction syndrome. PLoS One 10:e0132708CrossRef

Wang C, Nie PY (2016) Effects of asymmetric medical insurance subsidy on hospitals competition under non-price regulation. Int J Equity Health 15:184CrossRef

Wang C, Rao K, Wu S, Liu Q (2013) Health care in China: improvement, challenges, and reform. Chest 143:524–531CrossRef

Wang CN, Nguyen NT, Tran TT (2015) Integrated DEA models and grey system theory to evaluate past-to-future performance: a case of Indian electricity industry. Sci World J 2015:638710

Xu GC, Zheng J, Zhou ZJ, Zhou CK, Zhao Y (2015) Comparative study of three commonly used methods for hospital efficiency analysis in Beijing tertiary public hospitals, China. Chin Med J 128:3185–3190CrossRef

Yang CC (2017) Measuring health indicators and allocating health resources: a DEA-based approach. Health Care Manag Sci 20:365–378CrossRef

Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A (2012) Early appraisal of China’s huge and complex health-care reforms. Lancet 379:833–842CrossRef

Zhang H, Hu H, Wu C, Yu H, Dong H (2015) Impact of China’s public hospital reform on healthcare expenditures and utilization: a case study in ZJ Province. PLoS One 10:e0143130CrossRef

Title: Evaluation and analysis of hospital efficiency in China based on macro- and micro-level analyses
Authors: Lin Zhao
Lan Wang
Shu Li
Yao Zhang
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Published in: Journal of Public Health / Issue 2/2020
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-019-01048-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation and analysis of hospital efficiency in China based on macro- and micro-level analyses

Abstract

Aim

Subjects and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Subjects and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2020

Obesity and overweight—their impact on individual and corporate health

Healthcare needs of vulnerable patient groups: available data and existing gaps in Germany with respect to long-term mechanical ventilation

The effect of organizational and individual factors on health and safety practices: results from a cross-sectional study among manufacturing industrial workers

Studying the effect of a supportive communication techniques program on the quality gap among women who gave birth in local childbirth outposts, south-east Iran

The regular consumption of coffee and development of type 2 diabetes mellitus

Modelling the risk factors for injury severity in motorcycle users in Ghana