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Objective:To analyze the supply efficiency and influencing factors of medical and health services in 31 provinces in China from 2011 to 2020, providing reference for rational allocation of medical and health resources and improving service efficiency.Methods:The data related to the input-output indicators of China′s medical and health services from 2011 to 2020 were collected from China Health Statistical Yearbook, China Statistical Yearbook and China Social Statistical Yearbook. Data envelopment analysis was used to calculate the static efficiency of China′s medical and health service supply, the Malmquist index method was used to analyze the dynamic efficiency of China′s medical and health service supply, and the Tobit model was used to analyze the factors affecting the efficiency. Results:In 2020, the comprehensive efficiency of medical and health service supply in 15 provinces (Tianjin, Shanghai, Zhejiang, etc.) was 1.000, and the scale benefit remained unchanged. The comprehensive efficiency in 16 provinces (Heilongjiang, Jilin, Inner Mongolia, etc.) was less than 1.000. Among them, 15 provinces showed a decreasing scale benefit, while 1 province showed an increasing scale benefit.From 2011 to 2020, the total factor production efficiency index of China′s healthcare service supply increased from 0.988 to 1.036. The factors affecting the efficiency included number of people with a college degree or above per 10 000 people, the utilization rate of hospital bed rate, population density, asset liability ratio, and average length of stay ( P<0.05). Conclusions:In recent years, the efficiency of healthcare service supply in China showed a growth trend featuring regional differences and multiple influencing factors. It is suggested to further narrow the regional differences of the efficiency, reasonable control the scale of medical institutions, optimize medical service technology and management levels, shorten the average transfer day and improve bed utilization to improve the overall efficiency of medical and health service supply.
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Objective:To analyze the nursing efficiency of clinical departments in general hospitals under the background of medical insurance payment reform, and to explore the methods of rational allocation of resources and improvement of service efficiency.Methods:The relevant data of Qingdao Municipal Hospital from January to December 2020 were selected. The nursing efficiency of 20 clinical departments in the hospital was evaluated by data envelopment analysis (DEA) and Malmquist index. The input indexes were the number of nurses, the number of hours, the number of open beds. The output indicators were number of discharges, average length of stay, and case mix index.Results:In 2020, the average comprehensive efficiency, pure technical efficiency and scale efficiency of 20 clinical departments in the hospital were 0.845, 0.913 and 0.923, respectively.The total factor production efficiency index of the hospital from February to April, from May to September and from October to November were all greater than 1, but the total factor production efficiency index from January to December was less than 1. There were 5 departments with total factor production efficiency index greater than 1.Conclusions:The comprehensive nursing efficiency of clinical departments needs to be improved, and diagnosis related groups (DRG) poses a more severe challenge to the efficiency management of internal medicine nursing. The COVID-19 epidemic has a great impact on the efficiency of nursing services.It is feasible to evaluate the nursing efficiency with DEA model and DRG related indicators.Combined with the disease characteristics and nursing work characteristics of patients admitted to the department, the deep causes should be explored, comprehensive measures should be taken to improve nursing efficiency, precise nursing service transformation based on the reform of medical insurance payment mode should be explored, Internet + nursing service should be promoted, and the improvement of nursing resource efficiency under the status of normal epidemic prevention and control should be paid attention to.
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OBJECTIVE To evaluate the efficiency of drug safet y supervision in China after issuing a series of new policies in 2018，and to provide the suggestions for optimizing the construction of drug safety supervision system in China and narrowing regional differences. METHODS The panel data of input-output indexes of 18 provinces in 7 administrative regions were collected from the official website of provincial drug regulatory departments ，the open platform of budget and final accounts and the official website of National Bureau of Statistics. Data envelopment analysis （DEA）model and Malmquist index were adopted to conduct an empirical analysis on the efficiency of drug safety supervision in China during 2019-2020. RESULTS & CONCLUSIONS DEA analysis showed that during 2019-2020，the overall technical efficiency （TE）of drug safety supervision in China was lower than 1.000，which didn ’t meet effective DEA. Only Liaoning ，Guangdong and Guangxi had TE of 1.000，indicating significant differences in efficiency of drug safety supervision in different regions. The results of Malmquist index analysis showed that the overall efficiency of drug safety regulation in China was declining ，among which insufficient regulatory capacity supported by technology and large loss of professional personnel were the main factors ，and the improvement of drug regulatory departments ’ management and supervision level could ensure the improvement of overall regulatory efficiency. The current scale of drug supervision in nearly half of provinces （8/18）was close to the optimal state. It is necessary to strengthen the infrastructure construction and pay attention to the training of professional talents to optimize the drug regulatory team ；strengthen the innovation of supervision technology and improve the construction of technological support system ；rationally allocate regulatory resources and balance regional regulation according to local conditions to improve the construction of drug safety supervision system in China.
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Objective:To evaluate the scientific research efficiency and its change in a tertiary hospital, provide recommendations for improvement based on evaluation findings.Methods:We evaluated the scientific research efficiency of 35 disciplines in a tertiary hospital from 2015 to 2017 with BCC model of Data Envelopment Analysis and Malmquist index.Results:The number of DEA valid disciplines was 10, 16, 10 respectively. The average efficiency value from 2015 to 2017 of internal medicine, surgery department and supportive department was 0.62, 0.71, 0.74. The Total Factor Productivity of 2017, compared with 2015, was 1.30, which was mainly attributed to increase of Pure Technical Efficiency. There were 23 disciplines which efficiency increased and 12 disciplines which efficiency decreased.Conclusions:The scientific research efficiency of the tertiary hospital showed a rising trend. The efficiency of disciplines varied largely. For disciplines of DEA invalid or with downward trend, it is important to improve efficiency by improving management, cultivating talents, improving technology and increasing scientific output, and so on.
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OBJECTIVE：To evaluate the efficiency of drug safety supervision in Guangdong priovince and provide optimization suggestion for improving the construction of drug safety supervision system. METHODS ：Taking 21 cities in Guangdong province as samples ， the supervision input （supervision funds investment ， supervision and inspection of enterprises）-output（the rate of administrative penalty and qualified rate of sampling inspection ）data were collected from 2017 to 2018. Super-efficiency data envelopment analysis （DEA）model and Malmqusit index were used to analyze the efficiency of drug safety supervision from both static and dynamic point of view. RESULTS & CONCLUSIONS ：In static efficiency evaluation ， average drug safety supervision super-efficiency DEA in Guangdong province was 0.810，and the overall efficiency of drug safety supervision was in the low level ；among different cities ，there were obvious differences in supervision efficiency ；DEA values of only 5 cities（Shenzhen，Zhanjiang，Shaoguan，Qingyuan，Yangjiang）were higher than 1 and had achieved relatively effective results，while those of remaining cities were all invalid. In dynamic efficiency evaluation ，average Malmqusit index of drug safety supervision in Guangdong province was 0.787，which was decreased by 21.30％ in 2018 than 2017；the level of drug safety supervision in the whole province was declining ，and the main reason for the decline in the efficiency of drug safety supervision was technical backwardness ；technical efficiency played a promoter role in supervision efficiency to a certain extent. It is suggested that the efficiency improvement of drug safety supervision should further optimize resource allocation ，strengthen the level of supervision technical innovation ，expand the supervision scale ，and coordinate regional regulatory balance according to local conditions，so as to improve the construction of drug safety supervision system in Guangdong province.
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Objective To study the dynamic changes of scientific research efficiency of 51 departments in a top three hospitals in Beijing from 2014 to 2016,and to provide reference information for improving the efficiency of scientific research in hospital departments.Methods The CCC model of DEA,BCC model were used for lateral analysis,and then Malmquist index was used for longitudinal analysis.Results There were 12 (23.53％) departments in 2014,11 (21.57％) departments in 2015,9 (17.65％) departments in 2016 data envelopment analysis was valid,from 2014 to 2016,41 (80.39％) departments of the hospital increased the total factor productivity.Conclusions The total factor productivity of the 51 departments in the hospital increased from 2014 to 2016,and technological progress was the main reason for its growth.
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Objective To assess the total factor productivity (TFP) of schistosomiasis control programs in Jiangsu Province, so as to provide insights into sustainable schistosomiasis control. Methods The data envelopment analysis-Malmquist index method was employed to analyze the human resources and financial investments in schistosomiasis control programs from health sectors in each schistosomiasis-endemic city of Jiangsu Province from 2005 to 2015, and assess the outputs of each schistosomiasis control project. Results The overall productive efficiency of schistosomiasis control programs in Jiangsu Province showed an increasing tendency, and the mean fluctuation of annual TFP was 2.3%. The comprehensive technical efficiency, including pure efficiency and scale efficiency, appeared a steady increase with minor fluctuations, and the mean fluctuation of annual comprehensive technical efficiency was 3.8%. The growth rate of technical progress fluctuated greatly from 2005 to 2011, and showed a steady increase from 2012 to 2015, which became a major contributor to the growth of TFP. A higher growth rate of TFP was seen in Huai ‘ an and Changzhou cities, which showed a greater comprehensive technical efficiency, and a large fluctuation was observed in the growth rate of technical progress in Yancheng, Nanjing, Huai ’ an and Yangzhou cities. Conclusions There is a continuous improvement in the technical level of schistosomiasis control programs in Jiangsu Province, and technical application and supervision and management capacity also show a steady increase. In addition, the application of new techniques and new strategies contributes greatly to TFP growth. In the future, the investment into new techniques and new strategies should be increased to ensure the sustainable schistosomiasis control in Jiangsu Province.
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Objective To assess the total factor productivity (TFP) of schistosomiasis control programs in Jiangsu Province, so as to provide insights into sustainable schistosomiasis control. Methods The data envelopment analysis-Malmquist index method was employed to analyze the human resources and financial investments in schistosomiasis control programs from health sectors in each schistosomiasis-endemic city of Jiangsu Province from 2005 to 2015, and assess the outputs of each schistosomiasis control project. Results The overall productive efficiency of schistosomiasis control programs in Jiangsu Province showed an increasing tendency, and the mean fluctuation of annual TFP was 2.3%. The comprehensive technical efficiency, including pure efficiency and scale efficiency, appeared a steady increase with minor fluctuations, and the mean fluctuation of annual comprehensive technical efficiency was 3.8%. The growth rate of technical progress fluctuated greatly from 2005 to 2011, and showed a steady increase from 2012 to 2015, which became a major contributor to the growth of TFP. A higher growth rate of TFP was seen in Huai ‘ an and Changzhou cities, which showed a greater comprehensive technical efficiency, and a large fluctuation was observed in the growth rate of technical progress in Yancheng, Nanjing, Huai ’ an and Yangzhou cities. Conclusions There is a continuous improvement in the technical level of schistosomiasis control programs in Jiangsu Province, and technical application and supervision and management capacity also show a steady increase. In addition, the application of new techniques and new strategies contributes greatly to TFP growth. In the future, the investment into new techniques and new strategies should be increased to ensure the sustainable schistosomiasis control in Jiangsu Province.
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Introducción. En este artículo se presenta una metodología que permite que los colegios públicos (también llamados oficiales) de la ciudad de Barranquilla evalúen su desempeño respecto a otras instituciones oficiales y establezcan planes de mejoras potenciales para su organización. Objetivo. Evaluar y analizar, mediante la técnica de análisis envolvente de datos (DEA), la eficiencia relativa y la productividad de acuerdo con el índice de Malmquist en el uso de los recursos de los colegios oficiales del distrito de Barranquilla. Materiales y métodos. Se identificaron las variables de entradas y salidas mediante la metodología multicriterio y la aplicación de encuestas a expertos y se siguieron los lineamientos propuestos por Golany y Roll (1) para la utilización de la técnica DEA. Resultados. Los resultados de este estudio indican que, de los 148 colegios evaluados, 56 presentaron un incremento en su productividad, es decir, el 38% del total de las instituciones. Así mismo, se observó que en los años 2012 y 2013 el número de colegios eficientes fueron 54 y 57, respectivamente. Conclusión. Se evaluó la eficiencia considerando el modelo DEA CCR-O con retornos a escala constantes. El análisis de la eficiencia se efectuó teniendo en cuenta las cinco localidades del distrito de Barranquilla (Riomar, Norte-Centro Histórico, Metropolitana, Suroriente y Suroccidente) y se generaron los valores de eficiencia para los años 2012 y 2013.
Introduction. In this article is shown a methodology that allows each of the public schools of the city of Barranquilla to assses their performance with respect to other official institutions, providing them with the opportunity to establish plans for potential improvements for their organization. Objective. To evaluate and analyze through the Data Envelopment Analysis technique (DEA in Spanish), the relative efficiency and productivity with the Malmquist index regarding the use of resources of the public schools of the District of Barranquilla. Materials and methods. Identification of input and output variables using Multicriteria methodology and application of surveys to experts, following the guidelines proposed by Golany and Roll for the use of the DEA technique. Results. The results of this study indicate that, from the 148 schools analyzed, 56 had an increase in their productivity, that is, 38% of the total number of institutions. Likewise, it was observed that in the years2012 and 2013 the number of efficient schools are 54 and 57 respectively. Conclusion. The efficiency was evaluated considering the DEA CCR-O model with constant returns to scale. The efficiency analysis was carried out taking into account the five localities of the Barranquilla District (Riomar, Norte Centro Histórico, Metropolitana, Suroriente and Suroccidente), and efficiency values were generated for the years 2012 and 2013.
Introdução. Este artigo apresenta uma metodologia que permite que cada uma das escolas oficiais da cidade de Barranquilla avalie seu desempenho em relação às outras instituições oficiais, proporcionandolhes a oportunidade de estabelecer planos de melhorias potenciais para sua organização. Objetivo. Avaliar e analisar mediante a técnica de análise por envoltória de dados (DEA), a eficiência relativa e a produtividade com o índice de Malmquist no uso dos recursos das escolas oficiais do Distrito de Barranquilla. Materiais e métodos. Identificação de variáveis de entrada e saída usando metodologia multicritério e aplicação de pesquisas a especialistas e seguindo as diretrizes propostas por Golany e Roll para o uso da técnica DEA. Resultados. Os resultados deste estudo indicam que, das 148 escolas avaliadas, 56 tiveram aumento de produtividade, ou seja, 38% do total de instituições. Da mesma forma, observouse que nos anos de 2012 e 2013 o número de escolas eficientes é de 54 e 57, respectivamente. Conclusão. A eficiência foi avaliada considerando o modelo DEA CCR-O com retornos constantes de escala. A análise de eficiência foi feita tendo em conta as cinco localidades no Distrito de Barranquilla (Riomar, Norte Centro Histórico, Metropolitana, Suroriente e Suroccidente) e valores de eficiência para os anos de 2012 e 2013 foram gerados.
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In this study, medicine manufacturing technology innovation efficiency measures analyze and improve the competitiveness of the industry. The innovation rate of Chinese materia medica (CMM) manufacturing technology in Jiangsu Province (2009-2014) was analyzed according to statical panel data and dynamic given years by data envelopment analysis (DEA) and Malmquist index method. Chinese manufacturing innovation has overall higher efficiency of Jiangsu province, and Chinese medicine efficiency of technological innovation in manufacturing is higher than that of Chinese herbal pieces manufacturing. The proprietary manufacturing technology innovation inputs and outputs on the overall operation is relatively active; During six years, medicine manufacturing technology innovation efficiency in Jiangsu province has a certain magnitude of negative growth (-3.1%), efficiency of technological innovation presents zigzag upward trend; Medicine manufacturing technology innovation efficiency, Jiangsu Province, there are regional differences among cities. Through increased investment and innovation to achieve efficient use of resources, optimize the industrial structure and improve relevant policies, we can effectively improve the efficiency of technological innovation of Chinese manufacturing.
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Objective: To analyze the efficiency characteristics and trend of tertiary general public hospitals from both static and dynamic perspectives. Methods: After collecting data of personnel, equipment, assets, health services and other inputs-output indicators from 50 tertiary public hospitals from 2006 to 2012 , this paper uses C2 R-DEA and BC2-DEA models, as well as Malmquist Index model to build suitable analysis model. Results:About 10%~12% of the sample hospitals are in a relatively effective operational state, and the mean values of allocation effi-ciency and scale efficiency are 0. 956 and 0. 943, respectively, which are close to the efficient frontier. The mean values of pure technical efficiency, technical efficiency, cost efficiency and overall efficiency are 0. 796, 0. 784, 0. 714 and 0. 714, respectively, which are relatively poor compared with the efficiency frontier. Moreover, the number of hospitals that are in the state of diminishing returns to scale increased from 7 . 69% to 26 . 31%, while the number of hospitals that are in the state of increasing returns to scale decreased from 80. 77% to 58. 34%. The changes in techno-logical progress, Malmquist productivity index, technical efficiency index, pure technical efficiency index and scale effi-ciency index remained a relatively stable consistency, and showed continuous improvement and steady development trend. Conclusion:Tertiary general public hospitals are facing the transformation of driving force for development and incentive mechanisms. This needs not only to change the management concept and development mode of the hospitals, but also to build evaluation standards of optimum efficiency that are relevant to the structure, process and outcome, in order to pro-mote the transformation of hospital governance and development model that includes the functions of government.
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Objective To probe into the varying efficiency of public hospitals and recommend on efficiency improvement.Methods By means of DEA method including CCR model,BCC model and Malmquist index,to study the static and dynamic changes of operating efficiency of hospitals in Tianjin from 2008 to 2012.Results The overall efficiency of these 24 hospitals is not high,and the efficiency of the tertiary hospitals (0.900)is higher than the second-level hospitals(0.828).There exist problems that the size of the second-level hospitals is either too big or too small,a lot of health resources can be saved by managing the non-DEA efficient hospitals.The trends of the total factor productivity of 24 hospitals in Tianjin from 2008 to 2012 are increased.Thanks to the advanced technology and innovation, the overall efficiency of tertiary hospitals is improved.Through improving organizational management level,the overall efficiency of second-level hospitals is improved.Conclusion Hospital managers should introduce the high-level medical workers,enhance technological innovation,improve and standardize the hospital management and service system,optimize the allocation of medical resources and select the appropriate size of the hospital with the hospital's own situation to improve the operating efficiency of the public hospitals.
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Objective:To explore the productivity of township health services in Guangzhou. Methods:We use a nonparametric Malmquist index approach to analyze total factor productivity change in Guangzhou’s township health service. The panel data was collected between 2009 and 2013. Results: The average growth rate of Guangzhou’s township health service was 18 . 7% from 2009 to 2013 . This growth was mainly due to improved technical progress but not technical efficiency. Pure technical efficiency and scale efficiency have not developed simultaneously. Conclusion:The change in the total factor productivity was positively affected by technical progress, not by strategic management and business decisions inside township health centers.
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Objective:To analyze the efficiency and influencing factors of Chinese medical and health resources. Methods:Based on the panel data of 31 mainland provinces from 2003 to 2011 in China, use the two-stage Malmquist-Tobit model to analyze. Results:The efficiency of Chinese medical and health resources shows an increasing trend, which is dual driven by improvement of technical efficiency and technological progress. The efficiency varies among different areas, and the descending order of efficiency value is east, west and center. The level of economic development, population density, the proportion of profitable hospitals, the levels of urbanization and education can promote Chinese medical and health efficiency with different extent. Conclusion:To improve the efficiency of Chinese medical and health resources, it needs to promote economic development level, allocating health resources reasonably, and advancing urbanization and education levels orderly.
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Objective To measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.
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Objective To analyze the dynamic efficiency of township health centers. Methods Based on the DEA-Malmquist indices model, this paper analyzed the total factor productivity change indices of 281 township health centers in Hunan province with panel data from 2000 to 2008. These include technological change indices, efficiency change indices, pure technical efficiency change indices and scale efficiency change indices. Results A growth trend is identified with all the input/output factors in all the 281 township health centers; the sample health centers are found with a growth in the total factor productivity, efficiency and pure technical efficiency; the center health centers are found with a growth in the total factor productivity, technology, efficiency and pure technical efficiency, with greater technical improvement than efficiency; health centers at large are found with improvement in total factor productivity, efficiency and pure technical efficiency. Conclusion During the study period, sample health centers were characteristic of improved efficiency in terms of all factor productivity; central health centers characteristic of improvement in technology, while health centers at large are characteristic of improved efficiency.