Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Abstract

Background: Over the last decade, the expenditure on public medical and health has increased greatly in China, however, problems as low efficiency and unfairness still exist. How to accurately describe the effectiveness of existing medical and health resources in combination with regional heterogeneity is of great significance to China's medical and health reform.Methods: Based on provincial panel data for the period of 2005 to 2017, this paper constructs a super-efficiency three-stage SBM-DEA model, combining expected output and unexpected output, to measure and analyze the spatial-temporal heterogeneity characteristics and influencing factors of public medical and health efficiency (PMHE). Results: After the impacts of random error and external environmental factors are removed, the mean value of overall PMHE is 0.9274, failing to reach DEA efficiency, and PMHE shows a fluctuated downward trend. In addition, apart from eastern regions, the mean values of PMHE in central, western and north-eastern are all underestimated. (2) The adjusted PMHE level shows a prominent spatial imbalance at the stage 3. The average efficiency level is ranked by the east > the western > the central > the northeast region. (3) The increases of GDP per capita and population density are beneficial to the improvement of PMHE, while income level and education level are disadvantageous to PMHE, and the urbanization level, an uncertain effect.Conclusion: This study innovatively incorporates undesired outputs of health care into the efficiency evaluation framework by constructing the main efficiency evaluation indicators. The results of the robust evaluation conclude that China's existing investment in medical and health resources is generally not effective. Therefore, although China's health care reform has achieved certain results, it is still necessary to expand the investment in health care resources.

Performance evaluation for health‐care sectors using a dynamic network data envelopment analysis approach

“…Then Chinese government initiated a new round of health system reform in 2009 and emphasized that government would be the main source of public health-care input. Previous facts showed that although the investment in healthcare sector in China increased significantly, it was still insufficient and the utilization efficiency of health-care resources was low (Yi et al, 2020).…”

“…However, when the data ranged from 2009 to 2014, the efficiency of health-care system saw a slight increase over the time (Ding et al, 2018). Although there is a slight difference in the selection of inputs and outputs in these papers, they share a very similar definition of efficiency (Yi et al, 2020). Moreover, there is a research taking the quality as an additional output to measure the health-care service efficiency (Du, 2018).…”