Measuring productivity of healthcare services under environmental constraints: evidence from China

Abstract

Background: Despite the growing literature on the efficiency and productivity of the Chinese healthcare system, less attention has been given to examining the undesirable outputs linked to healthcare services, including environmental pollution. Taking the atmospheric environmental pollution resulting from the incineration of medical waste as an undesirable output of the healthcare system, this study analyzed the growth and decomposition of Total Factor Productivity (TFP) of healthcare services across 31 Chinese provinces during the period 2005-2016. Methods: The Meta-frontier undesirable super-efficiency slack-based measure (SBM) model and the Global Malmquist-Luenberger (GML) Index were employed to analyze the growth and decomposition of TFP using the Max DEA software. Results: The results revealed that the years 2009 and 2015 marked significant changes in TFP of healthcare services in Chinese provinces. During the study period, the rate of technological change (TC) slowly declined, whereas the rate of efficiency change (EC) steadily increased. With the national average being the benchmark, the results indicated that: the TFP of 17 provinces and cities exceeded the average, the EC of 16 provinces and cities exceeded the average, the TC of 9 provinces and cities exceeded the average, and the value in the Technology Gap Ratio (TGR) changes of 13 provinces and cities were above the national average. Conclusions: (1) The TFP of the healthcare services across China continued to decline slowly during the study period. (2) The effect of technical catch-up in the eastern, central, and western regions of China was significant across the three regions, whereas the effect of technical innovation was negative. (3) The TFP varied considerably among the Chinese provinces. These findings suggest that, under existing environmental constraints, relevant government departments should improve technical innovation in the supply of healthcare services and medical waste treatment, increase technical efficiency in the factor of healthcare production, strengthen regional health planning, and balance the development of regional healthcare.

Configuration Analysis of Influencing Factors of Technical Efficiency Based on DEA and fsQCA: Evidence from China’s Medical and Health Institutions

“…The operation level of medical and health institutions is not high, and it is necessary to introduce talents to improve their management level. Thirdly, the total factor productivity of medical and health institutions in China decreased by 3.5% annually from 2012 to 2017, mainly due to insufficient technological progress, which is slightly different from the research conclusion of Yu et al and Chen et al 32,33 Effech and Techch were 0.998 and 0.967, respectively, with an average annual decrease of 1.2% and 3.3%. Meanwhile, none of the provinces with falling TFP has achieved technological progress.…”

[Retracted] Exploration and Analysis of the Educational Management of University Students in the Context of Environmental Constraints

“…Mankelow, found that the teaching staff used a three-pronged approach to observe the students' development and use thought leadership to ensure that the students were able to relate their inner world to the reality of their thoughts [ 7 ]. Yu, et al took the initiative to look for problems in the course of teaching activities and raised them to the teaching staff to ensure that the teachers were able to provide answers to the students and understand the basic behavioral orientation of the students at the moment [ 8 ]. Samoilenko and Osei-Bryson, found that it was the only way to ensure that the school's party organization could play its true role in equipping students with the appropriate ideals and beliefs to meet the needs of teaching and learning activities, using theoretical learning, cultural activities, professional teaching and interaction to ensure that students have the correct world view, outlook on life and values [ 9 ].…”

Measuring operational efficiency of isolation hospitals during COVID-19 pandemic using data envelopment analysis: a case of Egypt

“…Similarly, Yu et al (2020) evaluated the efficiency of healthcare systems in 31 Chinese provinces during the period 2005-2016 based on changes in total factor productivity (TFP). The results confirmed that significant changes occurred in TFP in the period 2009-2016.…”