IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i24p9383-d462327.html
   My bibliography  Save this article

Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA

Author

Listed:
  • Zhensheng Chen

    (School of Management, Nanchang University, Nanchang 330031, China)

  • Xueli Chen

    (Institute of Journalism and Communication, Chinese Academy of Social Sciences, Beijing 100026, China)

  • Xiaoqing Gan

    (School of Management, Nanchang University, Nanchang 330031, China)

  • Kaixuan Bai

    (School of Management and Economics, Beijing Institute of Technology, Beijing 100081, China)

  • Tomas Baležentis

    (Lithuanian Institute of Agrarian Economics, Vilnius 03220, Lithuania)

  • Lixin Cui

    (School of Management and Economics, Beijing Institute of Technology, Beijing 100081, China)

Abstract

Many countries are facing the increasing cost of healthcare services and the low efficiency of public hospitals. These issues are also evident in China. This paper offers a comprehensive assessment of the efficiency of public hospitals operating in China’s 31 regions. The impact of the third round of reform of the health system in 2009 is assessed based on the three-stage data envelopment analysis procedure. The time period from 2011 to 2018 is covered in this study. Due to different functions performed by the public hospitals and other ones, the number of patients with infectious diseases is incorporated as an output variable reflecting the social function. The outpatient visits and inpatient visits are considered to reflect the outputs related to the private functions. The results imply an increase in the mean efficiency of public hospitals from 0.927 to 0.981 after taking the impact of environmental variables and statistic noise into account. These results indicate that the efficiency of public hospitals is dependent in the operational environment. There are 11 regions whose hospitals operate on the efficiency frontier during the whole period covered. Therefore, the Chinese government should reasonably design and apply the regulatory tools to improve the efficiency of public hospitals.

Suggested Citation

  • Zhensheng Chen & Xueli Chen & Xiaoqing Gan & Kaixuan Bai & Tomas Baležentis & Lixin Cui, 2020. "Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA," IJERPH, MDPI, vol. 17(24), pages 1-17, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:24:p:9383-:d:462327
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/24/9383/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/24/9383/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Paul Marschall & Steffen Flessa, 2011. "Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis," Health Economics Review, Springer, vol. 1(1), pages 1-15, December.
    2. Giménez, Víctor & Prieto, William & Prior, Diego & Tortosa-Ausina, Emili, 2019. "Evaluation of efficiency in Colombian hospitals: An analysis for the post-reform period," Socio-Economic Planning Sciences, Elsevier, vol. 65(C), pages 20-35.
    3. Jon A. Chilingerian & H. David Sherman, 2011. "Health-Care Applications: From Hospitals to Physicians, from Productive Efficiency to Quality Frontiers," International Series in Operations Research & Management Science, in: William W. Cooper & Lawrence M. Seiford & Joe Zhu (ed.), Handbook on Data Envelopment Analysis, chapter 0, pages 445-493, Springer.
    4. H. Fried & C. Lovell & S. Schmidt & S. Yaisawarng, 2002. "Accounting for Environmental Effects and Statistical Noise in Data Envelopment Analysis," Journal of Productivity Analysis, Springer, vol. 17(1), pages 157-174, January.
    5. Chowdhury, Hedayet & Zelenyuk, Valentin, 2016. "Performance of hospital services in Ontario: DEA with truncated regression approach," Omega, Elsevier, vol. 63(C), pages 111-122.
    6. Jondrow, James & Knox Lovell, C. A. & Materov, Ivan S. & Schmidt, Peter, 1982. "On the estimation of technical inefficiency in the stochastic frontier production function model," Journal of Econometrics, Elsevier, vol. 19(2-3), pages 233-238, August.
    7. Wasim Sultan & José Crispim, 2016. "Evaluating the Productive Efficiency of Jordanian Public Hospitals," International Journal of Business and Management, Canadian Center of Science and Education, vol. 12(1), pages 1-68, December.
    8. Erik Biørn & Terje Hagen & Tor Iversen & Jon Magnussen, 2010. "How different are hospitals’ responses to a financial reform? The impact on efficiency of activity-based financing," Health Care Management Science, Springer, vol. 13(1), pages 1-16, March.
    9. Marina Cavalieri & Calogero Guccio & Domenico Lisi & Giacomo Pignataro, 2018. "Does the Extent of per Case Payment System Affect Hospital Efficiency?," Public Finance Review, , vol. 46(1), pages 117-149, January.
    10. Hu, Hsin-Hui & Qi, Qinghui & Yang, Chih-Hai, 2012. "Analysis of hospital technical efficiency in China: Effect of health insurance reform," China Economic Review, Elsevier, vol. 23(4), pages 865-877.
    11. Moh'd M. Ajlouni & Amr Zyoud & Bashar Jaber & Haya Shaheen & Malik Al-Natour & Rami J. Anshasi, 2013. "The Relative Efficiency Of Jordanian Public Hospitals Using Data Envelopment Analysis And Pabon Lasso Diagram," Global Journal of Business Research, The Institute for Business and Finance Research, vol. 7(2), pages 59-72.
    12. Antonio Afonso & Miguel St. Aubyn, 2011. "Assessing health efficiency across countries with a two-step and bootstrap analysis," Applied Economics Letters, Taylor & Francis Journals, vol. 18(15), pages 1427-1430.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Shao-Wei Yang & Kuo-Chung Chu & Victor B. Kreng, 2021. "The Impact of Global Budgeting on the Efficiency of Healthcare under a Single-Payer System in Taiwan," IJERPH, MDPI, vol. 18(20), pages 1-14, October.
    2. Wei, Ming & Zhang, Shaopeng & Liu, Tao & Sun, Bo, 2023. "The adjusted passenger transportation efficiency of nine airports in China with consideration of the impact of high-speed rail network development: A two-step DEA-OLS method," Journal of Air Transport Management, Elsevier, vol. 109(C).
    3. Pengyu Ren & Zhaoxia Liu, 2021. "Efficiency Evaluation of China’s Public Sports Services: A Three-Stage DEA Model," IJERPH, MDPI, vol. 18(20), pages 1-12, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    2. Zhensheng Chen & Xueli Chen & Tomas Baležentis & Xiaoqing Gan & Vivian Valdmanis, 2020. "Productivity change and its driving forces in Chinese healthcare sector," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-16, December.
    3. Xian‐Hui He & Yung‐ho Chiu & Tzu‐Han Chang & Liang‐Chun Lu & Shih‐Yung Chiu, 2021. "Analyzing hospital medical efficiency of administration and medical treatment in China," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 42(6), pages 1564-1578, September.
    4. Juan Tang & Fangming Qin, 2022. "Analyzing the impact of local government competition on green total factor productivity from the factor market distortion perspective: based on the three stage DEA model," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 24(12), pages 14298-14326, December.
    5. Jean Pierre Huiban & Camille Mastromarco & Antonio Musolesi & Michel Simioni, 2016. "The impact of pollution abatement investments on production technology: new insights from frontier analysis," Working Papers hal-01512154, HAL.
    6. Angela Stefania Bergantino & Enrico Musso, 2011. "A Multi-step Approach to Model the Relative Efficiency of European Ports: The Role of Regulation and Other Non-discretionary Factors," Chapters, in: Kevin Cullinane (ed.), International Handbook of Maritime Economics, chapter 18, Edward Elgar Publishing.
    7. Tingting Wu & Junjun Chen & Chengchun Shi & Guidi Yang, 2023. "Carbon Emission Efficiency and Reduction Potential Based on Three-Stage Slacks-Based Measure with Data Envelopment Analysis and Malmquist at the City Scale in Fujian Province, China," Sustainability, MDPI, vol. 15(16), pages 1-15, August.
    8. Avkiran, Necmi K. & Rowlands, Terry, 2008. "How to better identify the true managerial performance: State of the art using DEA," Omega, Elsevier, vol. 36(2), pages 317-324, April.
    9. Vaninsky, Alexander, 2010. "Prospective national and regional environmental performance: Boundary estimations using a combined data envelopment – stochastic frontier analysis approach," Energy, Elsevier, vol. 35(9), pages 3657-3665.
    10. Sickles, Robin C. & Song, Wonho & Zelenyuk, Valentin, 2018. "Econometric Analysis of Productivity: Theory and Implementation in R," Working Papers 18-008, Rice University, Department of Economics.
    11. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    12. Qing Yin & Yadong Wang & Kaidi Wan & Delu Wang, 2020. "Evaluation of Green Transformation Efficiency in Chinese Mineral Resource-Based Cities Based on a Three-Stage DEA Method," Sustainability, MDPI, vol. 12(22), pages 1-29, November.
    13. Carla Henriques & Clara Viseu, 2022. "Are ERDFs Devoted to Boosting ICTs in SMEs Inefficient? A Three-Stage SBM Approach," Sustainability, MDPI, vol. 14(17), pages 1-20, August.
    14. Wang, Zhaohua & Li, Yi & Wang, Ke & Huang, Zhimin, 2017. "Environment-adjusted operational performance evaluation of solar photovoltaic power plants: A three stage efficiency analysis," Renewable and Sustainable Energy Reviews, Elsevier, vol. 76(C), pages 1153-1162.
    15. Zhang, Tiantian & Nakagawa, Kei & Matsumoto, Ken'ichi, 2023. "Evaluating solar photovoltaic power efficiency based on economic dimensions for 26 countries using a three-stage data envelopment analysis," Applied Energy, Elsevier, vol. 335(C).
    16. Meng Ye & Yanan Jin & Fumin Deng, 2022. "Municipal waste treatment efficiency in 29 OECD countries using three-stage Bootstrap-DEA model," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 24(9), pages 11369-11391, September.
    17. Zhang, Cai Wen & Yang, Yuanhui, 2023. "Appraisal of regional hospital efficiency and healthcare quality in China: Impacts of subsidies and marketization," Socio-Economic Planning Sciences, Elsevier, vol. 89(C).
    18. Iparraguirre, José Luis & Ma, Ruosi, 2015. "Efficiency in the provision of social care for older people. A three-stage Data Envelopment Analysis using self-reported quality of life," Socio-Economic Planning Sciences, Elsevier, vol. 49(C), pages 33-46.
    19. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.
    20. Haoran Zhao & Huiru Zhao & Sen Guo, 2018. "Operational Efficiency of Chinese Provincial Electricity Grid Enterprises: An Evaluation Employing a Three-Stage Data Envelopment Analysis (DEA) Model," Sustainability, MDPI, vol. 10(9), pages 1-18, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:24:p:9383-:d:462327. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.