Background: Hierarchical medical system (HMS) is a good policy to promote the fairness of medical services for residents. Given the importance of HMS, it is necessary to know the implementation effect of the policy. Therefore, we aimed to analyze the efficiency of medical service resources in China under the background of hierarchical medical policy. Methods: Based on the panel data of China's medical resources in 2015-2019, we used DEA model to calculate the technical efficiency (TE), pure technical efficiency (PTE) and scale efficiency (SE) of medical resources from both lateral and longitudinal aspects. We used Malmquist index to evaluate the change trend of efficiency, and further we compared the efficiency differences of regions and medical institutions. Results: In lateral evaluation results, TE was relatively stable, while total factor productivity (TFP) was on the rise. In longitudinal evaluation results, TE and TFP showed a downward trend. Conclusion: The government should consider the differences in development between regions and make health plans by regions. Medical institutions should strive to break down the constraints and make use of their advantages, which is conducive to improving efficiency.

China’s economy has grown rapidly in response to the adoption of a high-energy, high-emissions development model, which has led to varying degrees of air pollution; moreover, the corresponding health damage has become a major concern for the public. Studies of the interrelationships between the economy, air pollution, and health often use empirical methods such as regression analysis, to explore the impacts of economic growth and air pollution, human health or air pollution on human health in isolation, and they rarely explore the interactions between the economy, air pollution, and health in terms of efficiency (i.e., the maximum output per unit of input resources that can be produced). Thus, this study constructed a Dynamic Network SBM efficiency model that unifies the production of economic development, air pollution, and health into a single framework. The article reports the findings of a comprehensive study of economic development, air pollution, and health management data for 30 Chinese provinces from 2015 to 2020. The results show that: 1) the overall efficiency (0.693) of China’s two stages from economic production input to healthy output from 2015 to 2020 is low, and there is much room for improvement; 2) the efficiency of economic development (0.729) is higher than the efficiency of health production (0.657), indicating that the health production stage needs to be strengthened; 3) during the study period, China’s PM2.5, SO2, and NOx control efficiency was low, at 0.786, 0.710, and 0.718, respectively, indicating that more effective measures are needed to improve environmental efficiency; and 4) there are significant differences in economic, environmental, and health efficiency across regions. China’s developed eastern provinces are more efficient in terms of economic development, health production, and air pollution control. In contrast, the central and western provinces, which are relatively backward in their economic development, are less efficient. This means that each province should implement sound policies based on its own assessment to promote sustainable economic development while enhancing air pollution mitigation and health promotion.

Background In China, public health and medical care spending have significantly expanded over the past ten years, yet issues like inefficiency and injustice persist. It is crucial to figure out how to increase healthcare service efficiency if we are to improve the high-quality and effective medical and health services system and fulfill the inhabitants' increasingly diversified healthcare requirements. Methods Based on the panel data of China's medical resources in 2010–2020, we used SFA model to assess the effectiveness of healthcare services in 31 Chinese provinces. Kernel density estimation, spatial autocorrelation analysis, and Markov chains are used to examine the provinces' spatial-temporal features. Results In the efficiency assessment, although the efficiency of China's healthcare services has improved from 2010–2020, it is still at a medium level. Furthermore, inter-regional efficiency shows heterogeneous characteristics of high in the east and down in the west. In the spatial correlation, the spatial correlation between healthcare service efficiency is positive, and spatial agglomeration is dominated by homogeneous development, with a weakening tendency toward heterogeneous development. The type of healthcare services efficiency level is stable and difficult to transfer across provinces. After considering the spatial factor, although the basic pattern does not change, the type of neighborhood has a noticeable "near-neighbor effect" on the efficiency of local healthcare services. Conclusions (1) China's provinces should coordinate the regional allocation of high-quality medical and health resources following the level of regional economic development and the demand for medical services. (2) The government should fully use the spatial spillover effects between neighboring provinces to strengthen inter-regional cooperation and exchanges. (3) The top-ranked provinces should utilize their radiation-driven position to the fullest, and the provinces with lower healthcare service efficiency should take into account their development conditions and seek a balanced point of coordinated development between economic growth, resource allocation, and efficiency improvement.

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