Efficiency Comparison of Public Hospitals under Different Administrative Affiliations in China: A Pilot City Case.

Gang Yin, Chaoyi Chen, Lijun Zhuo, Qingjing He, Hongbing Tao
Author Information
  1. Gang Yin: Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China. ORCID
  2. Chaoyi Chen: Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
  3. Lijun Zhuo: Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China. ORCID
  4. Qingjing He: Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
  5. Hongbing Tao: Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.

Abstract

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.

Keywords

References

  1. PLoS One. 2017 Sep 8;12(9):e0184211 [PMID: 28886087]
  2. J Huazhong Univ Sci Technolog Med Sci. 2017 Oct;37(5):681-692 [PMID: 29058280]
  3. Int J Equity Health. 2017 May 25;16(1):89 [PMID: 28545456]
  4. Soc Sci Med. 2017 Apr;179:74-80 [PMID: 28260637]
  5. Health Care Manag (Frederick). 2015 Apr-Jun;34(2):106-12 [PMID: 25909397]
  6. Health Policy. 2013 Sep;112(1-2):70-9 [PMID: 23558262]
  7. Lancet. 2019 Sep 28;394(10204):1192-1204 [PMID: 31571602]
  8. Health Care Manag Sci. 2015 Dec;18(4):407-18 [PMID: 25515038]
  9. Soc Sci Med. 2009 Jun;68(12):2256-62 [PMID: 19419809]
  10. PLoS One. 2017 May 23;12(5):e0177946 [PMID: 28542362]
  11. Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Jun 18;49(3):483-488 [PMID: 28628151]
  12. Soc Sci Med. 2020 Jan;245:112715 [PMID: 31825797]
  13. BMC Public Health. 2018 Feb 5;18(1):214 [PMID: 29402260]
  14. Soc Sci Med. 2019 Apr;226:56-62 [PMID: 30844673]
  15. BMJ Open. 2015 Sep 09;5(9):e007267 [PMID: 26353864]
  16. Health Care Manag Sci. 2012 Dec;15(4):310-26 [PMID: 22297925]
  17. Lancet. 2012 Mar 3;379(9818):833-42 [PMID: 22386036]
  18. Med Care. 1992 Sep;30(9):781-94 [PMID: 1518311]
  19. Public Health. 2016 Sep;138:33-40 [PMID: 27129613]
  20. J Educ Health Promot. 2019 Jul 29;8:140 [PMID: 31463325]
  21. Health Policy. 2006 Jun;77(1):113-20 [PMID: 16154226]
  22. Eur J Health Econ. 2013 Dec;14(6):979-94 [PMID: 23229820]
  23. Int J Environ Res Public Health. 2018 Oct 16;15(10): [PMID: 30332771]
  24. Inquiry. 2015 Sep 21;52: [PMID: 26396090]
  25. BMC Health Serv Res. 2017 Dec 20;17(1):838 [PMID: 29262816]
  26. Appl Health Econ Health Policy. 2006;5(2):99-116 [PMID: 16872251]
  27. Eur J Health Econ. 2004 Oct;5(3):216-26 [PMID: 15714342]
  28. Lancet. 2009 Apr 18;373(9672):1322-4 [PMID: 19376436]
  29. J Med Syst. 2008 Jun;32(3):193-9 [PMID: 18444355]
  30. Health Policy. 2015 Mar;119(3):333-40 [PMID: 25533550]
  31. BMC Health Serv Res. 2014 Apr 06;14:158 [PMID: 24708701]
  32. Health Care Manag Sci. 2001 Jun;4(2):103-15 [PMID: 11393739]
  33. Int J Health Plann Manage. 2017 Jul;32(3):254-263 [PMID: 28589685]
  34. Int J Environ Res Public Health. 2019 May 07;16(9): [PMID: 31067779]
  35. Med Care. 1990 Jun;28(6):552-61 [PMID: 2355759]
  36. Int J Equity Health. 2016 Aug 23;15(1):131 [PMID: 27552805]
  37. Int J Health Plann Manage. 2019 Jan;34(1):414-442 [PMID: 30303272]
  38. Health Care Manag Sci. 2002 Feb;5(1):7-14 [PMID: 11860081]
  39. BMJ Open. 2016 Nov 11;6(11):e011911 [PMID: 27836870]
  40. Environ Monit Assess. 2017 Apr;189(4):181 [PMID: 28342048]
  41. Cost Eff Resour Alloc. 2014 Apr 08;12(1):9 [PMID: 24708886]
  42. J Health Serv Res Policy. 2007 Oct;12(4):230-5 [PMID: 17925075]
  43. J Med Syst. 2009 Aug;33(4):307-15 [PMID: 19697697]
  44. J Health Care Poor Underserved. 2013 Nov;24(4):1816-33 [PMID: 24185172]
  45. Health Policy. 2006 Aug;77(3):268-78 [PMID: 16129509]
  46. Health Policy. 2005 Jan;71(1):83-96 [PMID: 15563995]
  47. Health Serv Res. 2018 Apr;53(2):896-918 [PMID: 28266025]
  48. Soc Sci J. 2016 Dec;53(4):510-520 [PMID: 32288047]

Grants

  1. 71774061/National Natural Science Foundation of China