International College of Business and Technology, Tianjin University of Technology, Tianjin 300384, China.
School of Business and Economics, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada.
Int J Environ Res Public Health. 2019 May 7;16(9):1601. doi: 10.3390/ijerph16091601.
This study aimed to measure the efficiency and change in efficiency over time of township hospitals among Chinese provinces, to decompose the difference in efficiency between districts, and to study the correlations between the difference in efficiency and its determinants. Based on Chinese provincial panel data, the empirical analysis was established using data envelopment analysis (DEA), Malmquist index, Theil index decomposition method and Grey correlation analysis method. First, it was found that the township hospitals in most provinces were operating in an inefficient state, and the township hospitals in most provinces achieved gains in efficiency. Second, from 2003 to 2016 the shrinkage of the difference in provincial efficiency of township hospitals progressed slowly. Intra-regional difference is the main cause of the overall provincial efficiency difference of Chinese township hospitals, while inter-regional difference is the minor cause of the overall difference. Third, the correlation between the difference of overall provincial efficiency and the difference of economic development level is the highest among all the correlations, while other determinants rank second to seventh place in their degree of correlation with respect to the overall difference in provincial efficiency. Furthermore, the correlations between the intra-regional difference of provincial efficiency of Chinese township hospitals and its determinants vary tremendously across regions. Based on our findings, we can conclude, first, that efforts should be made to improve the overall provincial difference in efficiency of Chinese township hospitals, and enhance the utilization level of input resources, and to reduce resource waste. Second, in order to shrink the overall provincial efficiency of Chinese township hospitals, the most important measure that should be taken is to improve the economic development level in relatively backward provinces in order to lay a solid economic foundation for the improvement of efficiency and shrink the differences in efficiency between provinces. Third, more attention should be paid to the shrinkage of intra-regional efficiency differences in Chinese township hospitals, while the narrowing of inter-regional efficiency difference should not be ignored. For each region, it is necessary to recognize the difference in the relative importance of determinants, and to make development strategies according to local conditions so as to make full use of local characteristics and advantages.
本研究旨在衡量中国各省份乡镇卫生院的效率及其随时间的变化，并对效率差异进行分解，研究效率差异及其决定因素之间的相关性。基于中国省级面板数据，使用数据包络分析（DEA）、Malmquist 指数、泰尔指数分解方法和灰色关联分析方法进行实证分析。首先，发现大多数省份的乡镇卫生院运营效率低下，大多数省份的乡镇卫生院效率有所提高。其次，2003 年至 2016 年，乡镇卫生院省级效率差异的缩小速度缓慢。省内差异是造成中国乡镇卫生院省级整体效率差异的主要原因，而省际差异是造成整体差异的次要原因。第三，整体省级效率差异与经济发展水平差异的相关性在所有相关性中最高，而其他决定因素与省级效率整体差异的相关性次之至第七位。此外，中国乡镇卫生院省级效率的省内差异及其决定因素之间的相关性在不同地区差异巨大。根据我们的发现，可以得出以下结论：首先，应努力提高中国乡镇卫生院省级整体效率差异，提高投入资源的利用水平，减少资源浪费。其次，为了缩小中国乡镇卫生院省级整体效率，应采取的最重要措施是提高相对落后省份的经济发展水平，为提高效率和缩小省际效率差距奠定坚实的经济基础。第三，应更加关注中国乡镇卫生院省内效率差异的缩小，同时不能忽视省际效率差异的缩小。对于每个地区，有必要认识到决定因素相对重要性的差异，并根据当地情况制定发展战略，充分利用当地的特点和优势。
