Research on the Efficiency of China Health Service System Based on Three-stage DEA

Abstract

Abstract: The construction of health services is a hot issue that governments and the general public are concerned about. This paper takes primary medical and health care institution, hospitals and professional public health institutions as the research object; takes human and capital as the input index in the health service system; selects the output index from the main service items of the medical institutions; selects the per capita GDP, population density and government health expenditure as the environmental variables from three aspects: macroeconomy, social environment and policy support; and uses the three-stage DEA model to calculate the efficiency of health service system from 2010 to 2017. The empirical results show that: the efficiency of health service system is on the high side without considering the influence of environment and random interference. SFA regression analysis shows that external environment and random interference are important factors affecting the efficiency of health service system. The increase of per capita GDP and population density has little effect on the efficiency of health service system. Increased government health spending can drive efficiency improvements in health service system. After excluding the influence of factors, the average comprehensive efficiency of health medical service system is 0.802, mostly in a state of increasing scale. The largest decline in comprehensive efficiency occurs in Beijing, Tianjin and Hainan in the east region, Jilin in the central region, and Tibet, Ningxia and Qinghai in the west region. However, the overall efficiency is the highest in the east region and the lowest in the west region. The research further shows that the rational allocation of medical resources, the promotion of high-quality medical resources to the grass-roots level, and the improvement of the medical technology level of primary medical institutions will help to improve the overall efficiency of the regional health service system.

Key words: health service system, operational efficiency, three-stage DEA model

Yu Benhai, Wang Ting, He Chuang, Zheng Liwei, Guo Shouwei. Research on the Efficiency of China Health Service System Based on Three-stage DEA[J]. Management Review, 2022, 34(12): 312-321.

References

[1] 国务院办公厅. 国务院办公厅关于印发全国医疗卫生服务体系规划纲要(2015-2020年)的通知[EB/OL]. http://www.gov.cn/zhengce/content/2015-03/30/content_9560.htm, 2015-03-30
[2] 张冉,冉伦,李金林,等. 基于两阶段DEA Leader-Follower模型的固定成本分步分摊方法研究[J]. 管理评论, 2020,32(3):279-288
[3] Produo G., Lepchak A., Voese S. B. Evaluation of the Efficiency of Logistics Activities Using Data Envelopment Analysis (DEA)[J]. Gesto & Produo, 2020,27(1):1-20
[4] Zhang J., Wang S., Yang P., et al. Analysis of Scale Factors on China's Sustainable Development Efficiency Based on ThreeStage DEA and a Double Threshold Test[J]. Sustainability, 2020,12(6):1-27
[5] 刘凤朝,张娜,赵良仕. 东北三省高技术制造产业创新效率评价研究——基于两阶段网络DEA模型的分析[J]. 管理评论, 2020,32(4):90-103
[6] Nunamaker T. R. Efficiency Measurement and Medicare Reimbursement in Nonprofit Hospitals:An Investigation of the Usefulness of Data Envelopment Analysis[D]. Doctoral Dissertation, The University of Wisconsin-Madison, 1983
[7] Sherman H. D. Hospital Efficiency Measurement and Evaluation[J]. Medical Care, 1984,22(10):922-938
[8] 刘海英,张纯洪. 中国城乡地区医疗卫生系统服务效率的对比研究[J]. 中国软科学, 2011,(10):102-113
[9] Bilsel M., Davutyan N. Hospital Efficiency with Risk Adjusted Mortality as Undesirable Output:The Turkish Case[J]. Annals of Operations Research, 2014,221(1):73-88
[10] 夏昉,冷瑶,张瑞洁,等. 中国医改前后基层医疗机构服务效率变动分析[J]. 卫生经济研究, 2018,25(2):41-45
[11] 张怡青,王高玲. 基于DEA和RSR的我国基层医疗卫生机构服务效率评价[J]. 中国卫生事业管理, 2019,36(4):261-265
[12] 赵进进. 基于RBRVS基础上的医院综合绩效评价[J]. 管理世界, 2017,33(9):182-183
[13] 杜涛,冉伦,李金林,等. 基于DEA-DP组合方法的组织效率评价及资源配置——以首都医科大学附属医院为例[J]. 系统工程, 2017,35(12):131-140
[14] 庞瑞芝,高贤泽,邓忠奇. 公立医院"三重垄断"与医疗行业效率——基于我国省际面板数据的研究[J]. 当代经济科学, 2018,40(1):1-12
[15] Sang Q., Yao F., Hao S., et al. On Analysis of Tangshan Pre-Hospital Service Efficiency Based on Improved Fuzzy-DEA[J]. Open Access Library Journal, 2018,5(6):1-10
[16] Pirani N., Zahiri M., Engali K., et al. Hospital Efficiency Measurement Before and after Health Sector Evolution Plan in Southwest of Iran:A DEA-Panel Data Study[J]. Acta Informatica Medical, 2018,26(2):106-110
[17] Chen Y., Wang J., Zhu J., et al. How the Great Recession Affects Performance:A Case of Pennsylvania Hospitals Using DEA[J]. Annals of Operations Research, 2019,278(1-2):77-99
[18] Abolghasem S., Toloo M., Amézquita S. Cross-efficiency Evaluation in the Presence of Flexible Measures with an Application to Healthcare Systems[J]. Health Care Management Science, 2019,22(3):512-533
[19] Chitnis A., Mishra D. K. Performance Efficiency of Indian Private Hospitals Using Data Envelopment Analysis and Superefficiency DEA[J]. Journal of Health Management, 2019,21(2):279-293
[20] 王发连. 试论卫生监督机构的责任与效率[J]. 中国公共卫生管理, 2007,23(1):28-29
[21] 舒蝶,罗力,李伟,等. 上海市精神卫生服务床位需要测算和规划[J]. 中国卫生政策研究, 2011,4(9):26-30
[22] 高丽娜,马艺,白符,等. 2018年我国专业公共卫生机构及其人力资源配置现状与公平性分析[J]. 中国卫生经济, 2020,39(9):55-59
[23] 张新宇,任建萍,朱依滢,等. 中国专业公共卫生机构卫生资源配置公平性分析[J]. 中国预防医学杂志, 2019,20(8):641-645
[24] 胡玉杰. 地方医疗卫生公共服务供给效率的区域差异性[J]. 系统工程, 2018,36(5):150-158
[25] 肖力玮,邓汉慧. 医疗服务体系效率及其影响因素分析[J]. 统计与决策, 2019,35(11):106-110
[26] 顾海,许新鹏. 我国医疗服务体系运行效率及其影响因素:2011-2017[J]. 中国卫生政策研究, 2020,13(6):27-33
[27] 颜晓畅. 政府投入与不同地区医疗卫生机构静态和动态运营效率——基于DEA-Tobit方法的实证研究[J]. 南开经济研究, 2018,34(6):93-111
[28] 颜锦江,姜浩亮,程永忠,等. 供给侧结构性改革背景下医院投入产出效率评价——基于因子分析和DEA模型[J]. 财经科学, 2016,60(9):112-123
[29] Jiang N., Andrews A. Efficiency of New Zealand's District Health Boards at Providing Hospital Services:A Stochastic Frontier Analysis[J]. Journal of Productivity Analysis, 2020,53(1):53-68
[30] 王中华,李湘君. 补偿机制转化与公立医院产出效率驱动[J]. 系统工程, 2015,33(8):95-104
[31] 朱德云,袁月,高平. 财政分权对地方财政医疗卫生支出效率的非线性影响[J]. 财经科学, 2020,(8):118-132
[32] 罗颖,罗传建,彭甲超. 基于三阶段DEA的长江经济带创新效率测算及其时空分异特征[J]. 管理学报, 2019,16(9):1385-1393
[33] 易明,彭甲超,吴超. 基于SFA方法的中国高新技术产业创新效率研究[J]. 科研管理, 2019,40(11):22-31
[34] Fried H. O., Lovell C. A. K., Schmidt S. S., et al. Accounting for Environmental Effects and Statistical Noise in Data Envelopment Analysis[J]. Journal of Productivity Analysis, 2002,17(1):157-174
[35] 梅国平,龚雅玲,万建香,等. 基于三阶段DEA模型的华东地区物流产业效率测度研究[J]. 管理评论, 2019,31(10):234-241
[36] 陈巍巍,张雷,马铁虎,等. 关于三阶段DEA模型的几点研究[J]. 系统工程, 2014,32(9):144-149
[37] Wei Q. Data Envelopment Analysis[J]. Chinese Science Bulletin, 2001,46(16):1321-1332
[38] 洪瑾,王姝雯. 北京市医疗机构运营效率研究——基于DEA分析法[J]. 北京理工大学学报(社会科学版), 2014,16(1):70-75
[39] 陈伟,魏轩,李金秋,等. 上市公司社会网络位置与研发效率研究——基于三阶段DEA模型的方法[J]. 管理评论, 2020, 32(3):97-109
[40] 魏谷,汤鹏翔,杨晓非,等. 基于三阶段DEA的我国高新技术产业开发区内创新型产业集群创新效率研究[J]. 科技管理研究, 2021,41(7):155-163
[41] Shinagawa S., Tsuzuki E., Cellini R. Policy Lag and Sustained Growth[J]. Italian Economic Journal, 2019,5(3):403-431