Efficiency and productivity of county‐level traditional Chinese medicine hospitals in Hubei Province, China: A retrospective study based on 17 years of panel data

Abstract

Background The county‐level traditional Chinese medicine hospitals have significantly expanded in recent decades. This study aims to assess the changes in the efficiency and productivity of the county‐level traditional Chinese medicine hospitals and explore the possible causes of such changes. Methods Sixty one hospitals spanning from 2001 to 2017 were selected as samples in this study. And a slacks‐based measure of super‐efficiency in Data Envelopment Analysis and Malmquist index were used to respectively measure the changes in the efficiency and productivity. Results The scale of sample hospitals in Hubei continuously expanded from 2001 to 2017. The mean values of technical efficiency, pure technical efficiency and scale efficiency in 2017 were 0.686, 0.74 and 0.933, respectively. The technical efficiency changes in 2017 was 1.97 times that of 2001, and the technological changes in 2017 was 1.45 times that of 2001. Conclusions The medical environment and resources have been greatly improved due to the expansion of the sample hospitals, but the technical efficiency value indicates that the operation efficiency of sample hospitals still needs to be significantly improved. Decision‐makers are advised to attach importance to the efficiency of operation management and consider the impact of multiple factors on the change in productivity.

Measuring Productivity and Relative Efficiency of Public Tertiary Traditional Chinese Medicine Hospitals in Hubei, China

“…According to a longitudinal study among county-level TCM hospitals in Hubei Province from 2001 to 2017, the average TE score was 0.686, which was much lower than the scores (0.8391, 0.8048, and 0.8559) in our study. 14 Moreover, compared with another productivity and efficiency analysis study among municipal-level TCM hospitals in Gansu Province, the TE of tertiary TCM hospitals was reported to be 0.868, 0.926, and 0.935 from 2017 to 2019, slightly higher than those in our study. 28 One possible reason for this disparity could be the difference in the classification of TCM hospitals.…”

“… 10 , 11 Several studies have used the DEA/MPI models to measure the productivity and relative efficiency of TCM hospitals in China. 12 - 15 However, one limitation is that they incorporated all levels of TCM hospitals simultaneously, including primary, secondary and tertiary TCM hospitals, which resulted in biased results due to the heterogeneity across these different levels. Based on the Hospital Classification Management Measures in China, tertiary TCM hospitals represent the highest level and vary in capacity, structure of health professionals, and hospital settings.…”

“…Based on the Hospital Classification Management Measures in China, tertiary TCM hospitals represent the highest level and vary in capacity, structure of health professionals, and hospital settings. 14 Besides, the scores generated by classical DEA/MPI models were not adjusted, further contributing to bias. To address these limitations, Simar and Wilson suggest combining the classical DEA/MPI models with a Bootstrapping strategy to account for environmental and random factors.…”

Do China rural traditional Chinese medicine hospitals provide efficient healthcare to the people? Empirical study from 2013 to 2018 using data envelopment analysis

“…The improvement in rural TCM hospitals' performance has also been confirmed in other literatures. For example, an obvious growth in hospital efficiency was identified from lower than 0.5 to 0.686 during 2001-2017 in Hubei province [52], and efficiency improvements were also observed in Henan [26] and Shandong province [25]. The increase might benefit from the new round of rural hospital reform implemented in 2012 [53], which highlights the role and increases investment for rural TCM hospitals.…”

“…Although scholars have conducted empirical studies to investigate the efficiency of rural TCM hospitals, some deficiencies still remained: current studies focused on single province using cross-sectional or short panel data [20][21][22][23][24][25][26][27]; majority of these studies applied the traditional DEA model [20][21][22][23][24][25]. Therefore, this study attempts to investigate the technical efficiency of rural TCM hospitals across China from 2013 to 2018.…”