Jiang Wei, Yang Boyi, Dai Xiaoli, Li Shanshan
Department of Medicine, Jiangsu Medical College, Yancheng, China.
Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Public Health. 2025 Apr 23;13:1515532. doi: 10.3389/fpubh.2025.1515532. eCollection 2025.
Village clinics are essential for delivering primary health care in rural China, yet their resource allocation efficiency remains a concern. Many clinics face challenges such as low technical efficiency, imbalanced resource distribution, and insufficient technological progress, which may hinder the delivery of quality healthcare services.
This study evaluates the resource allocation efficiency of village clinics across 13 cities in Jiangsu Province, China, using Data Envelopment Analysis. The Malmquist Productivity Index was applied to assess efficiency changes over time, and Tobit regression was employed to identify influencing factors.
The overall efficiency of village clinic resource allocation in Jiangsu Province is suboptimal. In 2022, the average technical efficiency was 0.869, with seven cities classified as inefficient. Among them, three exhibited decreasing returns to scale, while four demonstrated increasing returns to scale. Reducing the number of village clinics and health technicians while increasing medical revenue could improve efficiency. From 2015 to 2022, the average Malmquist Productivity Index was 0.96, with a significant decline of 11.6% in 2021-2022, primarily due to a 6.8% decrease in technological change. Random-effects Tobit regression revealed that population density positively correlates with technical efficiency (coefficient = 0.0014, < 0.05), whereas per capita disposable income, healthcare fiscal expenditure, and urbanization rate showed no statistically significant effects.
The resource allocation efficiency of village clinics in Jiangsu Province is insufficient, with technological change being a key driver of efficiency fluctuations. Population density plays a significant role in efficiency variation. To enhance efficiency, optimizing resource allocation strategies and promoting technological advancements are essential for strengthening rural primary health care.
乡村诊所对于中国农村地区提供初级卫生保健至关重要，但其资源配置效率仍然令人担忧。许多诊所面临技术效率低下、资源分配不均衡和技术进步不足等挑战，这可能会阻碍优质医疗服务的提供。
本研究运用数据包络分析法评估了中国江苏省13个城市乡村诊所的资源配置效率。采用Malmquist生产率指数评估随时间的效率变化，并运用Tobit回归确定影响因素。
江苏省乡村诊所资源配置的整体效率欠佳。2022年，平均技术效率为0.869，有7个城市被归类为效率低下。其中，3个城市呈现规模报酬递减，而4个城市呈现规模报酬递增。减少乡村诊所和卫生技术人员数量，同时增加医疗收入可提高效率。2015年至2022年，平均Malmquist生产率指数为0.96，2021 - 2022年显著下降了11.6%，主要原因是技术变革下降了6.8%。随机效应Tobit回归显示，人口密度与技术效率呈正相关（系数 = 0.0014，< 0.05），而人均可支配收入、医疗卫生财政支出和城市化率未显示出统计学上的显著影响。
江苏省乡村诊所的资源配置效率不足，技术变革是效率波动的关键驱动因素。人口密度在效率变化中起重要作用。为提高效率，优化资源配置策略和促进技术进步对于加强农村初级卫生保健至关重要。
