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Has the Efficiency of China’s Healthcare System Improved after Healthcare Reform? A Network Data Envelopment Analysis and Tobit Regression Approach

by Guangwen Gong 1,2, Yingchun Chen 1,2,*, Hongxia Gao 1,2, Dai Su 1,2 and Jingjing Chang 1,2
1
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
2
Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(23), 4847; https://doi.org/10.3390/ijerph16234847
Received: 25 October 2019 / Revised: 28 November 2019 / Accepted: 29 November 2019 / Published: 2 December 2019
Background: A healthcare system refers to a typical network production system. Network data envelopment analysis (DEA) show an advantage than traditional DEA in measure the efficiency of healthcare systems. This paper utilized network data envelopment analysis to evaluate the overall and two substage efficiencies of China’s healthcare system in each of its province after the implementation of the healthcare reform. Tobit regression was performed to analyze the factors that affect the overall efficiency of healthcare systems in the provinces of China. Methods: Network DEA were obtained on MaxDEA 7.0 software, and the results of Tobit regression analysis were obtained on StataSE 15 software. The data for this study were acquired from the China health statistics yearbook (2009–2018) and official websites of databases of Chinese national bureau. Results: Tobit regression reveals that regions and government health expenditure effect the efficiency of the healthcare system in a positive way: the number of high education enrollment per 100,000 inhabitants, the number of public hospital, and social health expenditure effect the efficiency of healthcare system were negative. Conclusion: Some provincial overall efficiency has fluctuating increased, while other provincial has fluctuating decreased, and the average overall efficiency scores were fluctuations increase. View Full-Text
Keywords: healthcare system; efficiency; network data envelopment analysis; Tobit regression; healthcare reform healthcare system; efficiency; network data envelopment analysis; Tobit regression; healthcare reform
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Gong, G.; Chen, Y.; Gao, H.; Su, D.; Chang, J. Has the Efficiency of China’s Healthcare System Improved after Healthcare Reform? A Network Data Envelopment Analysis and Tobit Regression Approach. Int. J. Environ. Res. Public Health 2019, 16, 4847.

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