ABSTRACT
Objective: To analyze the effect of private hospitals development on the operational efficiency of public hospitals. Methods: The effect was performed using the Malmquist-Tobit Method. Results: The results found that from 2010 to 2015, the average factor of Total Productivity Index ( TPI) of the Chinese public hospitals was 1. 036 and the contribution rates of technological progress and technical efficiency were 66. 7% and 33. 3% , respec-tively. The coefficients of correlation between total productivity index, technological progress and technical efficiency were 0. 328, 0. 742. The structure optimization of private hospitals exerted a very significant inhibitory effect on the operating efficiency of public hospitals. The core resources of private hospitals were significantly promoted, and the number of public hospitals and scale of industries were not significant as per results revealed. Conclusion: The opera-tional efficiency of the public hospitals in China was in the overall improvement stage, but there was a threat of irreg-ular negative growth associated with regional and inter-provincial differentiation. The operational efficiency was driven by the technical progress and efficiency double paths. The effect of private hospitals on operational efficiency of pub-lic hospitals was characterized by heterogeneity, asymmetry and threshold characteristics under the framework of structural competition between private and public hospitals.
ABSTRACT
This paper analyzed the present situation on efficiency in hospitals and reasons for the failure of im-plementation. The analysis found that the research experienced a stage of fragmentation-dualization-systematic phase. The research subjects mainly included integrated or general hospitals (84. 21% ), hospitals of Grade II or above (55. 79% ), mixed and local systems (95. 26% ), and public hospitals dominated with 97. 89% , all of the subjects being covered from 22 provinces and municipalities. The comprehensive, technical and pure technical efficiencies had propor-tions of 87. 89% , 68. 84% and 86. 84 respectively and were concentrated in the research content, the evaluation meth-od being mainly DEA and and/or BCC (67. 89% ). The selection of indicators was mainly qualitative (47. 36% for pure literature analysis) and the main indicators were almost internally set. The first three were used in the frequency divi-sion outpatient emergency number (55 visits), number of beds and fixed assets (44) and total expenditures (42). The main sources of data were public access (27. 89% ), internal data (31. 05% ), investigations or various surveys (30. 53% ) and the hospitals’ own data reports (15. 26% ), and more than half (54. 21% ) was single road. Conclusion:The hospital efficiency evaluation focused on the integrated public hospitals above the grade two, mainly based on the relative efficiency of DEA, which involves many contents, wide geographical area and large span but the selection of in-dicators, data sources, and quantification of factors still restrict the quality of the results. The imbalance between the needs of researchers and managers for efficiency evaluation, inadequate understanding ad unbalanced knowledge togeth- er with the lack of relevant policies hindered the transformation of results. Therefore, the consistent mechanism for hospi-tals efficiency evaluation should be established from the angle of top-level design and actual situation of hospitals in China.
ABSTRACT
Objective:The main objective of this study is to evaluate the efficiency of China's heath resources al-location during 2004 to 2015 under the constraint of medical expenses control. Methods:To evaluate the efficiency of China's heath resources allocation,the undesired output Slacks-Based Measure(SBM) model was used. Results:As per the findings of this study,the efficiency of heath resources allocation at the national and regional levels of the undesired output SBM model was significantly lower than that of the traditional CCR model during 2004 to 2015. The non-expec-ted output redundancy rate and expected output deficiency rate at the national and regional levels were much greater than the input redundancy rate of health resources allocation of the national and regional levels. In addition,with re-dundancy rate introduction,the losses of health resource allocation efficiency in different provinces within the region were not the same. Conclusions:The efficiency of China's heath resources allocation was overestimated by the tradition-al DEA model,which was less sensitive to the change in its characteristics..Giving priority to non-expected output re-dundancy and expected output deficiency are the main reasons for the loss of health resource allocation in china,and are considered as internal and external improvement priorities for the performance of health resource allocation. It was suggested to establish the performance evaluation system of health resource allocation,which includes the integration of health resources input,expected-output and non-expected output,and evaluation techniques;and a mechanism for per-formance assessment and evaluation,supervision and feedback of health resource allocation should be established;and improve the implication of regional medical and health planning policies.