Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA
Abstract
:1. Introduction
2. Literature review
2.1. DEA Literature
2.2. Output Variables
3. Methods
3.1. Stage 1: Input-Oriented DEA
3.2. Stage 2: Effects of the Environmental Variables
3.3. Stage 3: Recalculation of the Efficiency Scores
4. Data
- (1)
- The number of licensed (assistant) doctors.
- (2)
- The number of other technical staff, including registered nurses, pharmacists, and other technicians.
- (3)
- The number of managers.
- (4)
- The number of beds.
- (1)
- The number of outpatient visits.
- (2)
- The number of inpatients visits.
- (3)
- The number of infectious patients treated in public hospitals.
- (1)
- The price of medical services. The high levels of medical service price have been a common concern in China. Indeed, high prices of the health services induce economic burden resulting in reduction in demand for medical services. The expenditure per outpatient visit and expenditure per inpatient visit are used to measure the price of outpatient services and the price of inpatient service respectively.
- (2)
- Insurance penetration. Due to the differences in medical insurance plans, the ratio of the covered by the basic medical insurance to population in a region is adopted to reflect the reform of medical insurance. The insurance penetration can affect both supply and demand side of medical services. As a professional third buyer, the insurance can force public hospitals to improve efficiency and quality of medical services, because insurance can adjust the patients’ demand for some hospital’ medical services via the reimbursement policies. Increasing insurance penetration allows sharing economic risks among the insured, so that patients access the medical services in a timely manner. Thus, reasonable medical insurance is expected to be positively related to the efficiency of public hospitals.
- (3)
- Public subsidies. Public subsidies represent government’s responsibility for medical service. The subsidy is measured by the ratio of government subsidies to the total public hospitals’ income. Public subsidies are expected to improve efficiency through hiring more skilled staff and purchasing advanced equipment. Still, a moral hazard problem may arise as public hospitals can survive even if they reduce their efforts to produce high-quality medical services.
- (4)
- Competition. Chinese government expects public hospitals to improve their performance through competition with for-profit hospitals. The ratio of the number of for-profit hospitals to total hospitals in a province is employed to measure the intensity of competition. The for-profit hospitals are expected to force public hospitals to get more revenue by improvement in quality and reduction in cost, which lead improvement in efficiency.
- (5)
- Quality of health services. The ratio of tertiary public hospitals to total hospitals in a region is employed to measure the quality of health services in the market. The higher the ratio, the better the quality of health services is expected. The tertiary hospitals can combinate the advanced medical equipment and skilled staff to provide more healthcare services. So, quality of health services is also expected to be positively correlated with hospital efficiency.
- (6)
- Demand for medical services. Children and elderly are likely to exhibit higher demand for health services. Thus, the ratio of population aged 0–14 and above 65 years to the total populations in a region is used to measure the demand for health service. In general, the increase in demand for medical service may lead to more skilled doctors, resulting in improvement in efficiency of public hospitals.
5. Results
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
Appendix A. The Input Slacks for 2011–2018
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | |
---|---|---|---|---|---|---|---|---|
Beijing | 15,988 | 17,439 | 16,407 | 17,250 | 19,517 | 19,511 | 18,934 | 26,551 |
Tianjin | 5378 | 5447 | 5453 | 5463 | 6799 | 7286 | 9051 | 9539 |
Hebei | 0 | 0 | 0 | 0 | 23,487 | 0 | 28,552 | 36,823 |
Shanxi | 23,643 | 23,135 | 23,623 | 23,553 | 23,805 | 22,814 | 22,191 | 24,189 |
Inner Mongolia | 9645 | 9935 | 11,070 | 10,310 | 11,528 | 11,415 | 10,622 | 11,218 |
Liaoning | 17,753 | 17,072 | 12,322 | 11,204 | 12,265 | 11,939 | 18,924 | 23,839 |
Jilin | 11,267 | 10,947 | 10,436 | 9590 | 11,596 | 12,557 | 11,693 | 13,443 |
Heilongjiang | 15,795 | 15,283 | 12,803 | 13,932 | 11,368 | 8533 | 0 | 14,340 |
Shanghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Jiangsu | 10,900 | 15,265 | 13,685 | 12,893 | 13,048 | 12,899 | 22,654 | 24,580 |
Zhejiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Anhui | 4479 | 7593 | 6128 | 5729 | 4238 | 6174 | 7403 | 9795 |
Fujian | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2752 |
Jiangxi | 1092 | 1283 | 355 | 0 | 0 | 0 | 0 | 2624 |
Shandong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Henan | 0 | 0 | 0 | 0 | 0 | 1380 | 2116 | 0 |
Hubei | 0 | 797 | 16 | 0 | 0 | 0 | 0 | 0 |
Hunan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangdong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangxi | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Hainan | 1263 | 1142 | 976 | 1015 | 1061 | 1051 | 0 | 1101 |
Chongqing | 1763 | 2107 | 3047 | 3451 | 3332 | 7399 | 5461 | 9853 |
Sichuan | 2720 | 3793 | 4734 | 7297 | 3107 | 0 | 44282 | 13,788 |
Guizhou | 3302 | 5047 | 4095 | 3088 | 3767 | 7375 | 4988 | 8345 |
Yunnan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tibet | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Shaanxi | 6977 | 6511 | 6569 | 6437 | 5563 | 8743 | 0 | 9614 |
Gansu | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Qinghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Ningxia | 291 | 0 | 269 | 538 | 262 | 1005 | 1224 | 939 |
Xinjiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | |
---|---|---|---|---|---|---|---|---|
Beijing | 22,027 | 22,244 | 19,163 | 21,677 | 24,009 | 21,775 | 15,439 | 30,828 |
Tianjin | 3608 | 3899 | 3552 | 3960 | 4922 | 5251 | 6280 | 7529 |
Hebei | 0 | 0 | 0 | 0 | 1393 | 0 | 4084 | 12,802 |
Shanxi | 24,065 | 22,495 | 26,430 | 26,594 | 28,948 | 29,939 | 34,729 | 31,797 |
Inner Mongolia | 9370 | 10,906 | 12,967 | 14,740 | 17,149 | 17,199 | 18,373 | 14,949 |
Liaoning | 23,256 | 22,359 | 19,623 | 18,182 | 16,119 | 19,724 | 23,526 | 32,817 |
Jilin | 10,402 | 9667 | 9820 | 9890 | 11,273 | 15,965 | 14,024 | 17,300 |
Heilongjiang | 18,059 | 18,409 | 16,669 | 16,516 | 14,166 | 13,564 | 0 | 17,891 |
Shanghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Jiangsu | 19,351 | 25,487 | 23,651 | 24,405 | 23,702 | 22,970 | 33,120 | 38,559 |
Zhejiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Anhui | 9038 | 12,332 | 11,271 | 10,592 | 11,090 | 11,779 | 8619 | 16,227 |
Fujian | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11,553 |
Jiangxi | 3790 | 4167 | 4023 | 0 | 0 | 0 | 0 | 10,323 |
Shandong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Henan | 0 | 0 | 0 | 0 | 0 | 2477 | 3765 | 0 |
Hubei | 0 | 637 | 29 | 0 | 0 | 0 | 0 | 0 |
Hunan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangdong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangxi | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Hainan | 3420 | 4135 | 4361 | 4979 | 5241 | 4927 | 0 | 6026 |
Chongqing | 3048 | 4721 | 5662 | 6536 | 7324 | 14,720 | 12,014 | 19,390 |
Sichuan | 4316 | 6328 | 8163 | 12,977 | 10,418 | 0 | 88,857 | 27,495 |
Guizhou | 6113 | 8345 | 7092 | 5826 | 7128 | 14,292 | 9681 | 16,525 |
Yunnan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tibet | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Shaanxi | 13,458 | 14,421 | 16,486 | 16,009 | 14,618 | 18,516 | 0 | 23,218 |
Gansu | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Qinghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Ningxia | 1988 | 0 | 1368 | 873 | 558 | 1391 | 3671 | 3279 |
Xinjiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | |
---|---|---|---|---|---|---|---|---|
Beijing | 4297 | 4414 | 4585 | 5249 | 5378 | 5071 | 4227 | 6749 |
Tianjin | 3357 | 3650 | 3660 | 3704 | 3491 | 3285 | 3290 | 3059 |
Hebei | 0 | 0 | 0 | 0 | 136 | 0 | 927 | 1796 |
Shanxi | 3266 | 3026 | 3607 | 3297 | 3387 | 4086 | 3861 | 4081 |
Inner Mongolia | 1068 | 1367 | 1906 | 2575 | 2757 | 2927 | 3134 | 3361 |
Liaoning | 3119 | 3612 | 3201 | 3071 | 2967 | 4196 | 4401 | 4808 |
Jilin | 3777 | 3937 | 4219 | 3971 | 4427 | 4896 | 4315 | 5256 |
Heilongjiang | 5106 | 5511 | 5370 | 5340 | 4872 | 4930 | 0 | 5639 |
Shanghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Jiangsu | 2149 | 2636 | 2259 | 2117 | 2158 | 1926 | 3407 | 4094 |
Zhejiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Anhui | 782 | 1204 | 1022 | 927 | 686 | 987 | 724 | 1350 |
Fujian | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 203 |
Jiangxi | 91 | 204 | 52 | 0 | 0 | 0 | 0 | 17 |
Shandong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Henan | 0 | 0 | 0 | 0 | 0 | 1423 | 2369 | 0 |
Hubei | 0 | 122 | 114 | 0 | 0 | 0 | 0 | 0 |
Hunan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangdong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangxi | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Hainan | 353 | 554 | 655 | 744 | 855 | 964 | 0 | 783 |
Chongqing | 994 | 1266 | 1815 | 2081 | 2503 | 4284 | 3986 | 3921 |
Sichuan | 2985 | 3278 | 4017 | 5763 | 3725 | 0 | 12,426 | 5308 |
Guizhou | 1095 | 1770 | 1371 | 871 | 1719 | 3095 | 2683 | 2964 |
Yunnan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tibet | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Shaanxi | 5009 | 5322 | 5929 | 6333 | 6635 | 7603 | 0 | 9077 |
Gansu | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Qinghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Ningxia | 52 | 0 | 44 | 90 | 7 | 157 | 361 | 256 |
Xinjiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | |
---|---|---|---|---|---|---|---|---|
Beijing | 7905 | 7454 | 3528 | 6888 | 4078 | 372 | 17,543 | 9866 |
Tianjin | 1257 | 4549 | 5876 | 7082 | 8128 | 7153 | 9681 | 9141 |
Hebei | 0 | 0 | 0 | 0 | 8614 | 0 | 25,582 | 42,245 |
Shanxi | 42,944 | 40,256 | 42,434 | 42,708 | 49,704 | 49,898 | 58,443 | 53,914 |
Inner Mongolia | 17,090 | 20,364 | 23,937 | 26,877 | 30,804 | 29,903 | 32,266 | 26,288 |
Liaoning | 44,460 | 43,789 | 38,802 | 39,751 | 33,600 | 51,487 | 67,758 | 76,685 |
Jilin | 21,486 | 20,162 | 21,162 | 21,180 | 23,816 | 33,927 | 28,612 | 34,953 |
Heilongjiang | 34,838 | 36,532 | 33,541 | 34,281 | 30,014 | 28,680 | 0 | 58,769 |
Shanghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Jiangsu | 43,864 | 56,405 | 60,558 | 62,028 | 54,313 | 59,537 | 81,385 | 84,580 |
Zhejiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Anhui | 14,126 | 22,141 | 20,333 | 19,187 | 14,475 | 21,021 | 15,582 | 29,533 |
Fujian | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4246 |
Jiangxi | 1569 | 3885 | 1137 | 0 | 0 | 0 | 0 | 456 |
Shandong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Henan | 0 | 0 | 0 | 0 | 0 | 33031 | 46339 | 0 |
Hubei | 0 | 1146 | 840 | 0 | 0 | 0 | 0 | 0 |
Hunan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangdong | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Guangxi | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Hainan | 847 | 1860 | 292 | 564 | 971 | 792 | 0 | 69 |
Chongqing | 15,108 | 21,897 | 27,185 | 26,650 | 35,344 | 29,069 | 46,442 | 38,057 |
Sichuan | 10,876 | 38,725 | 42,204 | 52,037 | 40,443 | 0 | 238,709 | 86,017 |
Guizhou | 10,696 | 20,792 | 25,462 | 39,597 | 41,320 | 29,004 | 48,153 | 32,432 |
Yunnan | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tibet | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Shaanxi | 21,091 | 20,591 | 22,086 | 33,954 | 32,117 | 30,009 | 0 | 32,417 |
Gansu | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Qinghai | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Ningxia | 878 | 0 | 1786 | 1638 | 122 | 2505 | 3682 | 2512 |
Xinjiang | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
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Reference | Context | Outputs |
---|---|---|
Li et al. [21] | Public hospitals in the Philippines | Total patients; Laboratory services; Net Death Rate |
Hu et al. [3] | Chinese regional hospitals | The total number of outpatient and emergency room visits; The total number of inpatient days; Patient mortality (undesired outputs). |
Ajlouni et al. [7] | Jordanian public hospitals | The annual number of patient days; Number of minor surgical operations per year; Number of major surgical operations per year. |
Barnum et al. [22] | Community hospitals in the Units States | Annual Inpatients; Annual Outpatients. |
Giénez et al. [23] | Colombian public hospitals | sum of the weighted services provided by hospitals’ relative value unit. |
Paul and Steffen [17] | The primary care facilities in rural Burkina Faso | General consultation and nursing care; Deliveries; Immunization; Special services. |
Sultan and Crispim [8] | Jordanian public hospitals | Inpatient days; Outpatient services; Ambulance and emergency services. |
Bin et al. [2] | Public hospitals in China | Number of outpatient and emergency visits; Number of discharged inpatients; Total revenue. |
Jing et al. [4] | Public hospitals in China | Outpatient and emergency visits; Inpatient discharges; Revenue. |
Xue [20] | China’s health care system | Outpatient visits; Discharged inpatients; Surgical operations; Successful rescue of critical patients. |
Category | Variable | Mean | S.D. | Min | Max |
---|---|---|---|---|---|
Inputs | Licensed doctors | 53,060 | 34,186 | 2341 | 166,567 |
Registered nurses | 92,026 | 59,535 | 1951 | 279,184 | |
Other technical staff | 9661 | 5593.021 | 367 | 23,898 | |
Beds | 164,182 | 106,077 | 5385 | 460,703 | |
Outputs | Infectious patients | 100,300 | 68,820 | 7061 | 387,240 |
Outpatient | 84,499,415 | 67,081,486 | 2,901,304 | 339,038,474 | |
Inpatients | 4,275,422 | 2,775,257 | 101,510 | 12,005,845 |
Correlates | Licensed Doctors | Registered Nurse | Other Technical Staff | Beds |
---|---|---|---|---|
Outpatient | 0.692 | 0.846 | 0.772 | 0.757 |
Inpatient | 0.767 | 0.955 | 0.861 | 0.946 |
Infectious patients | 0.689 | 0.718 | 0.665 | 0.704 |
Notation | Unit | Definition |
---|---|---|
Oprice | Yuan per visit | Average medical expenses of outpatients |
Iprice | Yuan per visit | Average medical expenses of inpatients |
Insura | % | ratio of the insured of basic medical insurance to population |
Subsid | % | ratio of government subsidy to the public hospital income |
Compet | % | ratio of the number of for-profit hospitals to total hospitals |
Qualit | % | ratio of tertiary public hospitals to total hospitals |
Demand | % | ratio of population aged 0–14 and above 65 years to populations |
Variable | Mean | S.D. | Min | Max |
---|---|---|---|---|
Oprice | 218.18 | 62.42 | 75.4 | 530.9 |
Iprice | 8574.63 | 3241.69 | 3906.3 | 22645.8 |
Insura | 0.4677 | 0.2538 | 0.1286 | 1.084 |
Subsid | 0.3267 | 0.0947 | 0.2009 | 0.7155 |
Compet | 0.4780 | 0.1504 | 0.0485 | 0.7846 |
Qualit | 0.0774 | 0.0312 | 0.0189 | 0.1574 |
Demand | 0.264 | 0.035 | 0.162 | 0.336 |
Province | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | Mean |
---|---|---|---|---|---|---|---|---|---|
Beijing | 0.91 | 0.92 | 0.963 | 0.933 | 0.961 | 0.997 | 0.846 | 0.915 | 0.931 |
Tianjin | 0.969 | 0.898 | 0.887 | 0.882 | 0.861 | 0.875 | 0.839 | 0.849 | 0.883 |
Hebei | 1 | 1 | 1 | 1 | 0.989 | 1 | 0.974 | 0.923 | 0.986 |
Shanxi | 0.612 | 0.664 | 0.669 | 0.681 | 0.646 | 0.661 | 0.621 | 0.67 | 0.653 |
Inner Mongolia | 0.765 | 0.752 | 0.739 | 0.729 | 0.707 | 0.727 | 0.728 | 0.792 | 0.742 |
Liaoning | 0.74 | 0.764 | 0.803 | 0.825 | 0.852 | 0.831 | 0.81 | 0.748 | 0.797 |
Jilin | 0.773 | 0.799 | 0.801 | 0.814 | 0.798 | 0.739 | 0.774 | 0.751 | 0.781 |
Heilongjiang | 0.731 | 0.741 | 0.778 | 0.79 | 0.827 | 0.842 | 1 | 0.804 | 0.814 |
Shanghai | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Jiangsu | 0.851 | 0.82 | 0.85 | 0.866 | 0.872 | 0.885 | 0.841 | 0.827 | 0.852 |
Zhejiang | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Anhui | 0.9 | 0.86 | 0.881 | 0.898 | 0.929 | 0.903 | 0.933 | 0.884 | 0.899 |
Fujian | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0.971 | 0.996 |
Jiangxi | 0.982 | 0.962 | 0.99 | 1 | 1 | 1 | 1 | 0.997 | 0.991 |
Shandong | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Henan | 1 | 1 | 1 | 1 | 1 | 0.988 | 0.983 | 1 | 0.996 |
Hubei | 1 | 0.993 | 1 | 1 | 1 | 1 | 1 | 1 | 0.999 |
Hunan | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Guangdong | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Guangxi | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Hainan | 0.96 | 0.919 | 0.988 | 0.979 | 0.968 | 0.975 | 1 | 0.998 | 0.973 |
Chongqing | 0.92 | 0.913 | 0.885 | 0.883 | 0.895 | 0.787 | 0.857 | 0.765 | 0.863 |
Sichuan | 0.96 | 0.95 | 0.943 | 0.918 | 0.967 | 1 | 0.584 | 0.878 | 0.900 |
Guizhou | 0.864 | 0.817 | 0.868 | 0.906 | 0.898 | 0.818 | 0.889 | 0.829 | 0.861 |
Yunnan | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Tibet | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Shaanxi | 0.816 | 0.838 | 0.846 | 0.857 | 0.885 | 0.834 | 1 | 0.841 | 0.865 |
Gansu | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Qinghai | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Ningxia | 0.96 | 1 | 0.969 | 0.943 | 0.996 | 0.922 | 0.894 | 0.93 | 0.952 |
Xinjiang | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Mean | 0.926 | 0.923 | 0.931 | 0.932 | 0.937 | 0.929 | 0.922 | 0.915 | 0.927 |
Efficient DMUs | 15 | 15 | 15 | 16 | 15 | 16 | 17 | 13 | 15.25 |
Province | Licensed Doctors | Registered Nurse | Other Technical Staff | Beds |
---|---|---|---|---|
Beijing | 18,950 | 22,145 | 4996 | 7204 |
Tianjin | 6802 | 4875 | 3437 | 6608 |
Hebei | 11,108 | 2285 | 357 | 9555 |
Shanxi | 23,369 | 28,125 | 3576 | 47,538 |
Inner Mongolia | 10,718 | 14,457 | 2387 | 25,941 |
Liaoning | 15,665 | 21,951 | 3672 | 49,541 |
Jilin | 11,441 | 12,293 | 4350 | 25,662 |
Heilongjiang | 11,507 | 14,409 | 4596 | 32,082 |
Shanghai | 0 | 0 | 0 | 0 |
Jiangsu | 15,741 | 26,406 | 2593 | 62,834 |
Zhejiang | 0 | 0 | 0 | 0 |
Anhui | 6442 | 11,369 | 960 | 19,550 |
Fujian | 344 | 1444 | 25 | 531 |
Jiangxi | 669 | 2788 | 46 | 881 |
Shandong | 0 | 0 | 0 | 0 |
Henan | 437 | 780 | 474 | 9921 |
Hubei | 102 | 83 | 29 | 248 |
Hunan | 0 | 0 | 0 | 0 |
Guangdong | 0 | 0 | 0 | 0 |
Guangxi | 0 | 0 | 0 | 0 |
Hainan | 951 | 4136 | 613 | 674 |
Chongqing | 4552 | 9177 | 2606 | 29,969 |
Sichuan | 9965 | 19,819 | 4688 | 63,627 |
Guizhou | 5001 | 9375 | 1946 | 30,932 |
Yunnan | 0 | 0 | 0 | 0 |
Tibet | 0 | 0 | 0 | 0 |
Shaanxi | 6302 | 14,591 | 5738 | 24,033 |
Gansu | 0 | 0 | 0 | 0 |
Qinghai | 0 | 0 | 0 | 0 |
Ningxia | 566 | 1641 | 121 | 1640 |
Xinjiang | 0 | 0 | 0 | 0 |
Environmental Variables | Input Slack Variables | |||
---|---|---|---|---|
Licensed Doctors | Registered Nurses | Other Technical Staff | Beds | |
Constant | 17,123.43 *** (713.82) | 21,039.96 *** (1453.02) | 5762.96 *** (345.2) | 21,653.04 *** (1.06) |
Oprice | 38.08 *** (14.32) | 63.35 *** (18.67) | 18.38 *** (4.6) | 88.86 ** (43.13) |
Iprice | −0.37 (0.29) | −1.2 *** (0.38) | −0.26 *** (0.07) | −1.72 * (1.02) |
Insura | 2155.1 * (1260.77) | 3207.5 * (1721.54) | 565.8 (390.04) | −4801.3 *** (1.01) |
Subsid | −1723.9 *** (308.9) | 4163.1 *** (591.78) | 968.3 *** (283.61) | −21,164.7 *** (1.01) |
Compet | 5609.2*** (2.07) | 11,418.7*** (812.85) | −559.5 (1013.59) | 48,806.9 *** (1.04) |
Qualit | −72,477.4 *** (49.34) | −58,172.4 *** (122.63) | −14,628.4 *** (649.94) | −102,167.1 *** (1) |
Demand | −79,566.6 *** (245.47) | −108,809.2 *** (408.48) | −26,107.1 *** (1098.74) | −141,534.5 ***(1) |
Sigma-squared | 74,340,902 *** (1) | 149,417,560 *** (1) | 5,798,688.6 *** (2.12) | 890,435,570 *** (1) |
γ | 0.79 *** (0.02) | 0.79 *** (0.02) | 0.83 *** (0.01) | 0.77 *** (0.02) |
Log likelihood | −2454.19 | −2533.56 | −2101.38 | −2761.6 |
One-sided LR Test | 132.22 *** | 143.60 *** | 180.09 *** | 133.2 *** |
Province | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | Mean |
---|---|---|---|---|---|---|---|---|---|
Beijing | 1 | 1 | 1 | 1 | 1 | 1 | 0.977 | 1 | 0.997 |
Tianjin | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Hebei | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0.974 | 0.997 |
Shanxi | 0.899 | 0.929 | 0.9 | 0.912 | 0.891 | 0.901 | 0.861 | 0.898 | 0.899 |
Inner Mongolia | 0.986 | 0.961 | 0.935 | 0.934 | 0.931 | 0.939 | 0.907 | 0.962 | 0.944 |
Liaoning | 0.879 | 0.897 | 0.925 | 0.941 | 0.948 | 0.943 | 0.926 | 0.879 | 0.917 |
Jilin | 0.957 | 0.977 | 0.983 | 0.98 | 0.975 | 0.95 | 0.955 | 0.945 | 0.965 |
Heilongjiang | 0.909 | 0.907 | 0.931 | 0.941 | 0.955 | 0.96 | 1 | 0.947 | 0.944 |
Shanghai | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Jiangsu | 0.947 | 0.914 | 0.92 | 0.936 | 0.935 | 0.935 | 0.905 | 0.897 | 0.924 |
Zhejiang | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Anhui | 0.967 | 0.969 | 0.971 | 0.986 | 0.976 | 0.974 | 0.968 | 0.96 | 0.971 |
Fujian | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0.998 | 1.000 |
Jiangxi | 0.964 | 0.965 | 0.975 | 1 | 1 | 1 | 0.972 | 0.989 | 0.983 |
Shandong | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Henan | 1 | 1 | 1 | 1 | 1 | 0.984 | 0.985 | 1 | 0.996 |
Hubei | 0.998 | 0.994 | 0.994 | 1 | 1 | 1 | 1 | 1 | 0.998 |
Hunan | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Guangdong | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Guangxi | 1 | 1 | 1 | 1 | 1 | 1 | 0.991 | 1 | 0.999 |
Hainan | 0.986 | 0.998 | 1 | 1 | 0.989 | 0.989 | 1 | 1 | 0.995 |
Chongqing | 0.991 | 0.99 | 1 | 1 | 1 | 0.964 | 1 | 0.95 | 0.987 |
Sichuan | 0.991 | 0.989 | 0.977 | 0.965 | 0.988 | 1 | 0.721 | 0.928 | 0.945 |
Guizhou | 0.965 | 0.948 | 0.957 | 0.982 | 0.98 | 0.958 | 0.988 | 0.959 | 0.967 |
Yunnan | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Tibet | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Shaanxi | 0.97 | 0.993 | 0.997 | 1 | 1 | 0.984 | 1 | 1 | 0.993 |
Gansu | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Qinghai | 0.993 | 1 | 0.995 | 1 | 1 | 1 | 1 | 1 | 0.999 |
Ningxia | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Xinjiang | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Mean | 0.981 | 0.982 | 0.983 | 0.986 | 0.986 | 0.983 | 0.973 | 0.977 | 0.981 |
Efficient DMUs | 16 | 17 | 18 | 22 | 21 | 19 | 19 | 18 | 18.75 |
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Chen, Z.; Chen, X.; Gan, X.; Bai, K.; Baležentis, T.; Cui, L. Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA. Int. J. Environ. Res. Public Health 2020, 17, 9383. https://doi.org/10.3390/ijerph17249383
Chen Z, Chen X, Gan X, Bai K, Baležentis T, Cui L. Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA. International Journal of Environmental Research and Public Health. 2020; 17(24):9383. https://doi.org/10.3390/ijerph17249383
Chicago/Turabian StyleChen, Zhensheng, Xueli Chen, Xiaoqing Gan, Kaixuan Bai, Tomas Baležentis, and Lixin Cui. 2020. "Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA" International Journal of Environmental Research and Public Health 17, no. 24: 9383. https://doi.org/10.3390/ijerph17249383