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. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. Chowdhury, Hedayet & Zelenyuk, Valentin, 2016. "Performance of hospital services in Ontario: DEA with truncated regression approach," Omega, Elsevier, vol. 63(C), pages 111-122.
    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. 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.
    5. 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.
    6. 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.
    7. 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.
    8. Jean Pierre Huiban & Camilla Mastromarco & Antonio Musolesi & Michel Simioni, 2016. "The impact of pollution abatement investments on production technology: new insights from frontier analysis," SEEDS Working Papers 0716, SEEDS, Sustainability Environmental Economics and Dynamics Studies, revised Jul 2016.
    9. 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).
    10. Glass, J.C. & McCallion, G. & McKillop, D.G. & Stringer, K., 2006. "A 'technically level playing-field' profit efficiency analysis of enforced competition between publicly funded institutions," European Economic Review, Elsevier, vol. 50(6), pages 1601-1626, August.
    11. Bao Hoang Nguyen & Zhichao Wang & Valentin Zelenyuk, 2023. "Efficiency of Queensland Public Hospitals via Spatial Panel Stochastic Frontier Models," CEPA Working Papers Series WP102023, School of Economics, University of Queensland, Australia.
    12. Geng Peng & Xiaodan Zhang & Fang Liu & Lijuan Ruan & Kaiyou Tian, 2021. "Spatial–temporal evolution and regional difference decomposition of urban environmental governance efficiency in China," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 23(6), pages 8974-8990, June.
    13. Linlin Cui & Long Chen & Xiao Yang, 2024. "Evaluation and analysis of green efficiency of China's coastal ports under the "double carbon" goal: two improved DEA models with CO2 emissions," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 26(11), pages 29099-29128, November.
    14. Huang, Tai-Hsin & Chiang, Dien-Lin & Lin, Chung-I, 2017. "A new approach to estimating a profit frontier using the censored stochastic frontier model," The North American Journal of Economics and Finance, Elsevier, vol. 39(C), pages 68-77.
    15. Bao Hoang Nguyen & Robin C. Sickles & Valentin Zelenyuk, 2021. "What do we know from the vast literature on efficiency and productivity in healthcare? A Systematic Review and Bibliometric Analysis," CEPA Working Papers Series WP092021, School of Economics, University of Queensland, Australia.
    16. Li, Ke & Lin, Boqiang, 2016. "Impact of energy conservation policies on the green productivity in China’s manufacturing sector: Evidence from a three-stage DEA model," Applied Energy, Elsevier, vol. 168(C), pages 351-363.
    17. Zhao, Haoran & Guo, Sen & Zhao, Huiru, 2019. "Provincial energy efficiency of China quantified by three-stage data envelopment analysis," Energy, Elsevier, vol. 166(C), pages 96-107.
    18. Jie Wu & Ganggang Zhang & Qingyuan Zhu & Zhixiang Zhou, 2020. "An efficiency analysis of higher education institutions in China from a regional perspective considering the external environmental impact," Scientometrics, Springer;Akadémiai Kiadó, vol. 122(1), pages 57-70, January.
    19. Puertas, Rosa & Marti, Luisa & Guaita-Martinez, José M., 2020. "Innovation, lifestyle, policy and socioeconomic factors: An analysis of European quality of life," Technological Forecasting and Social Change, Elsevier, vol. 160(C).
    20. Zeng, Shihong & Jiang, Chunxia & Ma, Chen & Su, Bin, 2018. "Investment efficiency of the new energy industry in China," Energy Economics, Elsevier, vol. 70(C), pages 536-544.

    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.