Research on the supply efficiency and influencing factors of provincial medical and health services in China / 中华医院管理杂志

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.

Health-related quality of life in patients with type 2 diabetes based on the European 5-Dimensional Health Scale / 公共卫生与预防医学

Objective To evaluate the quality of life of patients with type 2 diabetes mellitus in Weifang City, Shandong Province and to explore its influencing factors. Methods A multistage stratified random sampling method was used to investigate patients in endocrine outpatient clinics in four medical institutions in Weifang from July to September 2022. The survey included general information, multi-dimensional evaluation of quality of life with the EQ-5D-5L scale, calculation of health utility values, and analysis of influencing factors using Tobit regression models. Results A total of 397 patients with type 2 diabetes were included in the present investigation, with health utility value of 0.82±0.21 points and visual analogue scale (VAS) score of 79.47±12.81 points. Pain or discomfort, anxiety or depression were more prominent in the study population. Age, diabetic complications, BMI, daily need for care, social support, and daily level of glycemic control were factors influencing health-related quality of life in patients with type 2 diabetes. Conclusion In the actual treatment of type 2 diabetes patients, an emphasis should be placed on protecting elderly type 2 diabetic patients, preventing and controlling the occurrence and development of diabetic complications, and improving daily blood glucose control to further improve the health-related quality of life of the population.

Measurement of resource use efficiency in corn production: a two-stage data envelopment analysis approach in Turkey / Medição da eficiência do uso de recursos na produção de milho: uma abordagem de análise de dados em duas fases na Turquia

This research analyzed the efficiency situation of corn farms operating in the Adana province of Turkey. In this context, required farm management data were collected from 111 corn farmers by using face to face survey method during the 2019-2020 cultivation season. To determine the technical efficiency (TE) levels of corn farms, Data Envelopment Analysis (DEA) was applied. Furthermore, factors that cause the inefficiency in corn farms were detected by using the Tobit regression model. According to research results, the average TE levels of corn farms in the research area under the variable return to scale conditions are reported as 0.887 (111 farms). These results suggested that if farms reduced their input use by 11.3% on average, they can achieve the same output level and be able to reach full technical efficiency. The most ineffective source in terms of farms performance is machine expenditures with 68.2% of excessive use followed by labor use. In this regard, mechanization modernization, education and training of the labor force and more sensitive fertilizers and pesticide use can increase the efficiency of corn farms. Results of the Tobit regression model indicated that factors such as experience, education, number of tractors and size of the irrigated area positively influenced the TE, whereas family size in corn farming has a negative effect.

Esta pesquisa tem como objetivo analisar a situação de eficiência das fazendas de milho operando na província de Adana, na Turquia. Neste contexto, os dados necessários de gestão da fazenda foram coletados de 111 produtores de milho usando o método de pesquisa frente a frente durante a temporada de cultivo de 2019-2020. Para determinar os níveis de eficiência técnica (TE) das fazendas de milho, foi aplicada a Análise Envoltória de Dados (DEA). Além disso, os fatores que causam a ineficiência nas fazendas de milho foram detectados por meio do modelo de regressão Tobit. De acordo com os resultados da pesquisa, os níveis médios de TE das fazendas de milho na área de pesquisa sob as condições de retorno variável à escala são encontrados em 0,887 (111 fazendas). Esses resultados sugerem que, se as fazendas reduzirem o uso de insumos em 11,3% em média, podem atingir o mesmo nível de produção e alcançar eficiência técnica plena. A fonte mais ineficaz em termos de desempenho das fazendas são os gastos com máquinas, com 68,2% do uso excedente continuado com o uso de mão de obra. Nesse sentido, a mecanização, a modernização, a educação e o treinamento da força de trabalho e o uso de fertilizantes e pesticidas mais sensíveis podem ser sugeridos para aumentar a eficiência das fazendas de milho. Os resultados do modelo de regressão Tobit indicam que fatores como experiência, escolaridade, número de tratores e tamanho da área irrigada influenciaram positivamente no TE, enquanto o tamanho da família na cultura do milho tem efeito negativo.

Study on the operational efficiency and influencing factors for county-level public hospitals in Jiangsu province: a study based on the super-efficiency DEA model and Tobit model / 中华医院管理杂志

Objective To analyze the static and dynamic efficiency of the county-level public hospitals in Jiangsu province, and the influencing factors of efficiency. Methods The static and dynamic efficiency of 43 such hospitals was analyzed using the super-efficiency DEA and the Malmquist index method, and the influencing factors were studied using the Tobit regression model. Results Overall efficiency of the 43 county-level public hospitals varies significantly, mostly found in their technical efficiency. From 2014 to 2015, the total factor productivity index of some hospitals declined, mostly due to declining technical efficiency changing index. The efficiency is positively correlated to the location of the hospital, medical personnel, and the ratio of beds available. On the other hand, the efficiency is a negatively correlated to hospital grading, drug proportion per 100 yuan medical income. Conclusions Differential strategies are recommended to improve their operational efficiency, by optimizing hospital resource allocation, rationalizing hospital scale, and improving internal management system.

Study on the Efficiency of Public Hospitals' Medical Service and Its Influencing Factors in Tianjin / 中国卫生经济

Objective:To analyze the efficiency of 77 public hospitals' medical services and influencing factors in Tianjin.Methods:Using DEA method to measure the hospitals' medical service efficiency,establishing Tobit regression model to analyze the influencing factors of public hospitals medical service efficiency.Results:The overall efficiency of Tianjin public hospitals was low,most hospitals were not reasonable in the size,the significant influencing factors of Tianjin public hospitals' medical service efficiency including the per capita physician outpatient,the proportion of senior technical staffs,hospital gearing ratio,drug-income ratio and average fee per patient.Conclusion:Increasing the per capita physician outpatient and the proportion of senior technical staff could significantly enhance the overall technical efficiency,while decreasing the gearing ratio and the average fee of per patient were also beneficial to improve hospital efficiency.

Analysis on Chinese Medical and Health Resources Efficiency-based on two-stage Malmquist-Tobit Empirical Analysis / 中国卫生经济

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.

Policy Implications of Droughts and Floods Adaptation on Household Crop Production and Food Security in Southern Malawi.

Aims: This paper quantified the contribution of drought and flood related adaptation strategies on household food production and food security. Place and Duration of Study: It was conducted in lowland and highland areas of southern Malawi and data was collected from randomly sampled households using a semi-structured questionnaire. Methodology: The paper employed a Translog production function and a Tobit model to determine the effects of drought and flood related adaptation strategies on food production and food security. About 1000 households were randomly selected to participate in the household survey. Fifty percent of the respondents were from lowland areas while the remaining 50% was from highland areas of Southern Malawi. Results: Results show that households in the study area adapted through irrigation farming, income-generating activities, crop diversification and shifting planting dates. Irrigation farming significantly increased food production by 8% and 6% and improved food availability by 24% and 19% in low and highland areas, respectively (p<0.05). On the other hand, shifting crop-planting dates reduced food production by 24% and 37% and food availability by 20% and 11% at 5% level of significance in low and highland areas, respectively. Conclusion: This paper concluded that adaptation strategies have very interesting and significant policy implications on household crop production and food security. It is therefore suggested that decisions by policy/decision makers on household food production and availability should strive at mainstreaming droughts and floods related adaptation.