Yin Gang, Chen Chaoyi, Zhuo Lijun, He Qingjing, Tao Hongbing
Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
Healthcare (Basel). 2021 Apr 8;9(4):437. doi: 10.3390/healthcare9040437.
This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.
本研究旨在利用2013年至2017年的面板数据，从行政隶属关系的角度衡量中国中部武汉市三级综合公立医院的效率差异和生产率变化。样本医院分为三类，即省级医院、市级医院和其他级别的医院。采用具有自抽样技术的数据包络分析来估计效率得分，并通过考虑非期望产出改变模型设定进行敏感性分析以检验估计的稳健性，同时利用Malmquist指数进行效率演变分析。结果表明，在此期间省级医院和市级医院的平均值均出现了效率提升，特别是在公立医院改革试点启动之后，但其他隶属关系的医院则呈现相反趋势。与此同时，公立医院在技术效率上出现了行政隶属差异，且这种差异可能会随着时间的推移而扩大。与省级和其他行政隶属关系的医院相比，市级隶属医院的效率更高，这可能归因于更好的治理和组织结构。
