The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China
Abstract
:1. Introduction
2. Methods and Materials
2.1. Data Sources
2.2. Analytical Methodology
2.3. Sample Selection
2.4. Variable Selection
- Primary hospitals have 100 or fewer beds, directly provide the local communities with medical care, preventive care, and other integrated services, and are the primary health care institutions.
- Secondary hospitals have between 101 and 500 beds and are regional hospitals that provide comprehensive healthcare services to multiple communities.
- Tertiary hospitals have more than 500 beds; provide hospital and other health services at the municipal, regional, provincial, and national levels; and are medical prevention and technology centers with the ability to conduct comprehensive healthcare, teaching, and research activities.
Variables | Definition | |
---|---|---|
Input variables | Doctors | Number of doctors in each EMRRT |
Nurses | Number of nurses in each EMRRT | |
Sickbeds | Number of sickbeds in each EMRRT | |
Output variables | Number of injured patients | Number of people receiving treatment for injuries sustained in the earthquake daily |
Number of non-injured patients | Number of people treated daily for other (non-earthquake) medical problems | |
Control Variables | Date | Rescue date |
0 = 4/14, 1 = 4/15, 2 = 4/16, 3 = 4/17, 4 = 4/18 | ||
Area | EMRRT’s region of origin | |
1 = Yushu, 2 = Regions in Qinghai Province, 3 = Regions outside of Qinghai Province | ||
Source | Type of institution to which each EMRRT belonged | |
1 = primary hospital, 2 = secondary hospital, 3 = tertiary hospital | ||
Staff-to-bed ratio | Staff-to-bed ratio of each EMRRT | |
Doctor-to-nurse ratio | Doctor-to-nurse ratio of each EMRRT |
2.5. DEA Model Orientation
2.6. Data Analysis
3. Results
3.1. Descriptive Statistics and Analysis
DMU | Date | Area | Source | S-B Ratio | D-N Ratio | Doctors | Nurses | Sickbeds | NIP | NNIP |
---|---|---|---|---|---|---|---|---|---|---|
A-1 | 4/15 | 2 | 3 | 3.00 | 2.00 | 8 | 4 | 4 | 112 | 4 |
A-2 | 4/16 | 2 | 3 | 3.00 | 2.00 | 8 | 4 | 4 | 89 | 21 |
A-3 | 4/17 | 2 | 3 | 3.00 | 2.00 | 8 | 4 | 4 | 22 | 38 |
A-4 | 4/18 | 2 | 3 | 3.00 | 2.00 | 8 | 4 | 4 | 18 | 40 |
B-2 | 4/16 | 2 | 2 | 3.40 | 2.40 | 12 | 5 | 5 | 77 | 42 |
B-3 | 4/17 | 2 | 2 | 3.33 | 1.86 | 13 | 7 | 6 | 39 | 51 |
B-4 | 4/18 | 2 | 2 | 3.33 | 1.86 | 13 | 7 | 6 | 13 | 57 |
C-0 | 4/14 | 2 | 2 | 2.25 | 0.80 | 4 | 5 | 4 | 102 | 0 |
C-1 | 4/15 | 2 | 2 | 2.25 | 0.80 | 4 | 5 | 4 | 93 | 0 |
C-2 | 4/16 | 2 | 2 | 2.25 | 0.80 | 4 | 5 | 4 | 32 | 26 |
C-3 | 4/17 | 2 | 2 | 2.25 | 0.80 | 4 | 5 | 4 | 13 | 35 |
C-4 | 4/18 | 2 | 2 | 2.25 | 0.80 | 4 | 5 | 4 | 8 | 31 |
D-1 | 4/15 | 2 | 2 | 2.33 | 0.75 | 6 | 8 | 6 | 78 | 22 |
D-2 | 4/16 | 2 | 2 | 2.33 | 0.75 | 6 | 8 | 6 | 59 | 28 |
D-3 | 4/17 | 2 | 2 | 2.33 | 0.75 | 6 | 8 | 6 | 27 | 31 |
D-4 | 4/18 | 2 | 2 | 2.33 | 0.75 | 6 | 8 | 6 | 14 | 32 |
E-0 | 4/14 | 2 | 2 | 3.50 | 1.33 | 4 | 3 | 2 | 74 | 3 |
E-1 | 4/15 | 2 | 2 | 3.50 | 1.33 | 4 | 3 | 2 | 61 | 5 |
E-2 | 4/16 | 2 | 2 | 3.50 | 1.33 | 4 | 3 | 2 | 30 | 10 |
E-3 | 4/17 | 2 | 2 | 3.50 | 1.33 | 4 | 3 | 2 | 12 | 18 |
E-4 | 4/18 | 2 | 2 | 3.50 | 1.33 | 4 | 3 | 2 | 5 | 29 |
F-0 | 4/14 | 2 | 3 | 2.75 | 4.50 | 9 | 2 | 4 | 78 | 20 |
F-1 | 4/15 | 2 | 3 | 2.75 | 4.50 | 9 | 2 | 4 | 76 | 18 |
F-2 | 4/16 | 2 | 3 | 2.75 | 4.50 | 9 | 2 | 4 | 52 | 22 |
F-3 | 4/17 | 2 | 3 | 2.75 | 4.50 | 9 | 2 | 4 | 21 | 35 |
F-4 | 4/18 | 2 | 3 | 2.75 | 4.50 | 9 | 2 | 4 | 9 | 28 |
G-0 | 4/14 | 1 | 1 | 2.00 | 3.00 | 15 | 5 | 10 | 117 | 9 |
G-1 | 4/15 | 1 | 1 | 2.00 | 3.00 | 15 | 5 | 10 | 78 | 36 |
G-2 | 4/16 | 1 | 1 | 2.00 | 3.00 | 15 | 5 | 10 | 31 | 33 |
G-3 | 4/17 | 1 | 1 | 2.00 | 3.00 | 15 | 5 | 10 | 27 | 61 |
G-4 | 4/18 | 1 | 1 | 2.00 | 3.00 | 15 | 5 | 10 | 14 | 62 |
H-0 | 4/14 | 1 | 1 | 3.00 | 5.00 | 10 | 2 | 4 | 81 | 5 |
H-1 | 4/15 | 1 | 1 | 3.00 | 5.00 | 10 | 2 | 4 | 60 | 22 |
H-2 | 4/16 | 1 | 1 | 3.00 | 5.00 | 10 | 2 | 4 | 24 | 33 |
H-3 | 4/17 | 1 | 1 | 3.00 | 5.00 | 10 | 2 | 4 | 13 | 27 |
H-4 | 4/18 | 1 | 1 | 3.00 | 5.00 | 10 | 2 | 4 | 7 | 29 |
I-0 | 4/14 | 1 | 1 | 2.33 | 6.00 | 6 | 1 | 3 | 76 | 9 |
I-1 | 4/15 | 1 | 1 | 2.33 | 6.00 | 6 | 1 | 3 | 17 | 22 |
I-2 | 4/16 | 1 | 1 | 1.67 | 4.00 | 4 | 1 | 3 | 5 | 17 |
I-3 | 4/17 | 1 | 1 | 1.67 | 4.00 | 4 | 1 | 3 | 4 | 10 |
I-4 | 4/18 | 1 | 1 | 1.67 | 4.00 | 4 | 1 | 3 | 4 | 9 |
J-2 | 4/16 | 3 | 3 | 3.00 | 1.00 | 3 | 3 | 2 | 32 | 18 |
J-3 | 4/17 | 3 | 3 | 3.00 | 1.00 | 3 | 3 | 2 | 11 | 21 |
J-4 | 4/18 | 3 | 3 | 1.50 | 2.00 | 2 | 1 | 2 | 5 | 12 |
K-2 | 4/16 | 3 | 3 | 2.00 | 1.00 | 4 | 4 | 4 | 34 | 18 |
K-3 | 4/17 | 3 | 3 | 2.00 | 1.00 | 4 | 4 | 4 | 14 | 20 |
K-4 | 4/18 | 3 | 3 | 2.00 | 1.00 | 4 | 4 | 4 | 10 | 23 |
L-1 | 4/15 | 3 | 1 | 3.00 | 2.00 | 2 | 1 | 1 | 23 | 10 |
L-2 | 4/16 | 3 | 1 | 3.00 | 2.00 | 2 | 1 | 1 | 13 | 12 |
L-3 | 4/17 | 3 | 1 | 3.00 | 2.00 | 2 | 1 | 1 | 7 | 10 |
L-4 | 4/18 | 3 | 1 | 3.00 | 2.00 | 2 | 1 | 1 | 6 | 6 |
M-2 | 4/16 | 2 | 3 | 1.38 | 4.50 | 18 | 4 | 16 | 76 | 21 |
M-3 | 4/17 | 2 | 3 | 1.38 | 4.50 | 18 | 4 | 16 | 42 | 25 |
M-4 | 4/18 | 2 | 3 | 1.50 | 5.00 | 20 | 4 | 16 | 14 | 41 |
N-0 | 4/14 | 2 | 3 | 2.20 | 1.20 | 12 | 10 | 10 | 152 | 27 |
N-1 | 4/15 | 2 | 3 | 2.20 | 1.20 | 12 | 10 | 10 | 134 | 49 |
N-2 | 4/16 | 2 | 3 | 2.20 | 1.20 | 12 | 10 | 10 | 67 | 44 |
N-3 | 4/17 | 2 | 3 | 2.20 | 1.20 | 12 | 10 | 10 | 23 | 76 |
N-4 | 4/18 | 2 | 3 | 2.20 | 1.20 | 12 | 10 | 10 | 15 | 77 |
0-2 | 4/16 | 3 | 3 | 1.85 | 1.06 | 19 | 18 | 20 | 76 | 52 |
0-3 | 4/17 | 3 | 3 | 1.90 | 1.11 | 20 | 18 | 20 | 38 | 51 |
0-4 | 4/18 | 3 | 3 | 1.90 | 1.11 | 20 | 18 | 20 | 10 | 75 |
3.2. Technical Efficiency Scores
Statistic | Value of Variables | CRSTE | VRSTE | Scale Efficiency | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean (%) | SD | 100% TE | Mean (%) | SD | 100% TE | Mean (%) | SD | 100% TE | ||
Date | 0 | 59.9 | 0.154 | 8.70% | 99.5 | 0.002 | 17.39% | 60.15 | 0.153 | 8.70% |
1 | 87.27 | 0.022 | 0.00% | 95.47 | 0.041 | 33.33% | 91.62 | 0.057 | 16.67% | |
2 | 73.03 | 0.192 | 9.09% | 87.97 | 0.11 | 27.27% | 82.57 | 0.169 | 9.09% | |
3 | 72.99 | 0.22 | 18.18% | 85.89 | 0.145 | 27.27% | 83.91 | 0.176 | 18.18% | |
4 | 77.07 | 0.172 | 18.18% | 90.03 | 0.117 | 45.45% | 85.86 | 0.164 | 36.36% | |
Area | 1 | 53.3 | 0 | 0.00% | 99.4 | 0 | 0.00% | 53.6 | 0 | 0.00% |
2 | 79.59 | 0.158 | 14.71% | 91.12 | 0.113 | 44.12% | 86.95 | 0.12 | 23.53% | |
3 | 70.76 | 0.248 | 22.22% | 86.4 | 0.123 | 22.22% | 81.58 | 0.245 | 22.22% | |
Source | 1 | 53.3 | 0 | 0.00% | 99.4 | 0 | 0.00% | 53.6 | 0 | 0.00% |
2 | 82.97 | 0.142 | 23.53% | 90.59 | 0.111 | 35.29% | 91.5 | 0.1 | 35% | |
3 | 74.32 | 0.198 | 11.54% | 89.83 | 0.12 | 53.85% | 82.12 | 0.171 | 15.38% | |
Summary statistics | 70.25 | 0.188 | 11.29 | 92.97 | 0.105 | 27.42 | 75.95 | 0.196 | 16.13 |
3.3. Tobit Analysis Results
Variables | CRSTE | VRSTE | Scale Efficiency | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Coef. | SD | P | 95% CI | Coef. | SD | P | 95% CI | Coef. | SD | P | 95% CI | |
date | −0.036 | 0.020 | 0.085 | −0.076–0.005 | −0.051 | 0.019 | 0.012 | −0.089–0.012 | 0.014 | 0.020 | 0.476 | 0.054–0.026 |
area | 0.026 | 0.058 | 0.654 | 0.142–0.090 | −0.052 | 0.052 | 0.318 | −0.156–0.052 | 0.120 | 0.069 | 0.087 | 0.018–0.259 |
Source | −0.026 | 0.038 | 0.495 | −0.103–0.05 | 0.060 | 0.036 | 0.100 | 0.012–0.130 | −0.128 | 0.046 | 0.007 | −0.220–0.036 |
S-B Ratio | 0.116 | 0.044 | 0.011 | 0.204–0.028 | 0.077 | 0.041 | 0.064 | 0.005–0.158 | 0.088 | 0.042 | 0.043 | 0.003–0.173 |
D-N Ratio | 0.002 | 0.020 | 0.939 | 0.042–0.039 | −0.014 | 0.018 | 0.462 | −0.050–0.023 | 0.022 | 0.020 | 0.281 | 0.018–0.062 |
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Liu, X.; Tang, B.; Yang, H.; Liu, Y.; Xue, C.; Zhang, L. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China. Int. J. Environ. Res. Public Health 2015, 12, 15390-15399. https://doi.org/10.3390/ijerph121214991
Liu X, Tang B, Yang H, Liu Y, Xue C, Zhang L. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China. International Journal of Environmental Research and Public Health. 2015; 12(12):15390-15399. https://doi.org/10.3390/ijerph121214991
Chicago/Turabian StyleLiu, Xu, Bihan Tang, Hongyang Yang, Yuan Liu, Chen Xue, and Lulu Zhang. 2015. "The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China" International Journal of Environmental Research and Public Health 12, no. 12: 15390-15399. https://doi.org/10.3390/ijerph121214991