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      Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China

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          Abstract

          Background:

          China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis (DEA) model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development.

          Methods:

          We chose 12 country-level hospitals based on geographical distribution and the economic development level in Anhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions.

          Results:

          During 2010–2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was >1, and the rest are <1 between 2010 and 2015.

          Conclusions:

          In 2010–2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.

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          Most cited references19

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          The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity

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            Non-parametric and parametric applications measuring efficiency in health care.

            This paper reviews 188 published papers on frontier efficiency measurement. The techniques used are mainly based on non-parametric data envelopment analysis, but there is increasing use of parametric techniques, such as stochastic frontier analysis. Applications both to hospitals and wider health care areas are reviewed and summarised, and some meta-type analysis undertaken. Results appear to confirm earlier findings that public provision demonstrates less variability than private. The paper is meant as a resource in itself, but also points to the future in terms of possible directions for research in efficiency measurement in health care and health.
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              IDEA and AR-IDEA: Models for Dealing with Imprecise Data in DEA

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                Author and article information

                Journal
                Chin Med J (Engl)
                Chin. Med. J
                CMJ
                Chinese Medical Journal
                Medknow Publications & Media Pvt Ltd (India )
                0366-6999
                05 December 2017
                : 130
                : 23
                : 2836-2843
                Affiliations
                [1 ]Department of Research Administration Office (NNL), First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
                [2 ]Department of Dean's Office, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
                [3 ]Department of Health Services Management, School of Health Administration, Anhui Medical University, Hefei, Anhui 230032, China
                [4 ]Department of Dean's Office, Children's Hospital of Anhui Province, Hefei, Anhui 230000, China
                Author notes
                Address for correspondence: Prof. Heng Wang, Department of Dean's Office, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China E-Mail: wanghengteam@ 123456163.com
                Article
                CMJ-130-2836
                10.4103/0366-6999.219148
                5717863
                29176142
                edcb1c40-cf92-4a27-949c-98d92233a326
                Copyright: © 2017 Chinese Medical Journal

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 17 August 2017
                Categories
                Original Article

                china,county level public hospital,data envelopment analysis,malmquist index,service efficiency

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