Prediction and Decomposition of Efficiency Differences in Chinese Provincial Community Health Services

Liu, Qian; Li, Bo; Mohiuddin, Muhammad

doi:10.3390/ijerph15102265

Cited by 26 publications

(28 citation statements)

References 34 publications

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“…Other scholars have estimated the public health efficiency in Greece [ 32 ], India [ 33 ], Lebanon [ 34 ], México [ 35 ], and Slovakia [ 36 ]. Some scholars have deeply discussed China’s public health efficiency, and respectively calculated and studied the Chinese provincial community health service efficiency [ 37 , 38 , 39 , 40 , 41 , 42 ] and the allocation efficiency of the public health resources in the coastal provinces of China [ 43 ]. A few scholars have preliminarily analyzed the allocation efficiency of the rural public health resources [ 44 , 45 ].…”

Section: Introductionmentioning

confidence: 99%

“…To sum up, the research results of scholars such as Kawaguchi [ 9 ], Jat [ 17 ], Li [ 22 ], Liu [ 37 ], and Xue [ 45 ] on the measurement of the allocation efficiency of the public health resources and its influencing factors provide a great deal of experience as a reference for the study of this paper. Compared with the existing studies, this paper has three main contributions.…”

Section: Introductionmentioning

confidence: 99%

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Regional Differences and Influencing Factors of Allocation Efficiency of Rural Public Health Resources in China

Liu

Chen

et al. 2020

Healthcare

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In the face of increasingly growing health demands and the impact of various public health emergencies, it is of great significance to study the regional differences in the allocation efficiency of the rural public health resources and its improvement mechanism. In this paper, the game competition relationship is included in the evaluation model, and the game cross-efficiency model is used to measure the allocation efficiency of the rural public health resources in 31 provinces of China from 2008 to 2017. Then, the Theil index model and the Gini index model are applied in exploring the regional differences in the allocation efficiency of rural public health resources and its sources. Finally, the bootstrap truncated regression model is used to analyze the influencing factors of the allocation efficiency of the rural public health resources in China. The results show that, first, the total allocation efficiency level of the rural public health resources in China from 2008 to 2017 is relatively low, and it presents a U-shaped trend, first falling and then rising. Second, the changing trend of the allocation efficiency of the rural public health resources in the eastern, central, and western regions of China is similar to that in the nationwide region, and it shows a gradient trend that “the allocation efficiency in the eastern region is high, the allocation efficiency in the western region is low, and the allocation efficiency in the Central region is at the medium level”. However, the gap among the three regions is continually narrowing. Third, the calculation results of the Theil index and the Gini index show that intra-regional differences are the major source of the regional differences in the allocation efficiency of the rural public health resources in China, and the inter-regional differences demonstrate an expansion trend. Finally, the improvement of the education level and the social support level will generally improve the allocation efficiency of the rural public health resources in China and its three regions. The increased governmental financial support and urbanization level will reduce the allocation efficiency of the rural public health resources in China and its three regions. The economic development level, the living conditions and the population density are the important influencing factors of the allocation efficiency differences of the rural public health resources in the three regions. Therefore, on the basis of ensuring the increase of the total supply of the rural public health resources, more attention should be paid to the improvement of the allocation efficiency. Moreover, on the basis of continually narrowing the inter-regional differences among the eastern, central, and western regions, more attention should be paid to the intra-regional differences of the allocation efficiency of the rural public health resources among the different provinces. The various economic and social policies should be constantly optimized to jointly improve the allocation efficiency of the rural public health resources.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Regional Differences and Influencing Factors of Allocation Efficiency of Rural Public Health Resources in China

Liu

Chen

et al. 2020

Healthcare

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“…Scholars usually evaluate PHC from two perspectives-institutions and regions-and some scholars evaluate the specific services, such as oral health care in PHC [17][18][19]. In China, studies from the perspectives of institutions and provinces have shown that the efficiency of PHCIs is low [20][21][22][23]. However, there are few studies that have evaluated the efficiency of PHCIs from the perspective of counties.…”

Section: Introductionmentioning

confidence: 99%

The Efficiency of Primary Health Care Institutions in the Counties of Hunan Province, China: Data from 2009 to 2017

Zhong

Cheng

et al. 2020

IJERPH

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This study aimed to estimate the efficiency and its influencing factors of Primary Health Care Institutions (PHCIs) in counties in Hunan Province, China, and put forward feasible suggestions for improving the efficiency of PHCIs in Hunan Province. We applied the Input-Oriented Data Envelopment Analysis (DEA) method and the Malmquist Index Model to estimate the efficiency of PHCIs in 86 counties in Hunan Province from 2009 to 2017. Then, the Tobit model was used to estimate the factors that influence the efficiency of PHCIs. Since the implementation of the new health-care reform in 2009, the number of health resources in PHCIs in Hunan Province has increased significantly, but most counties’ PHCIs remain inefficient. The efficiency of PHCIs is mainly affected by the total population, city level, the proportion of health technicians and the proportion of beds, but the changes in per capita GDP have not yet played a significant role in influencing efficiency. In the future, the efficiency of PHCIs should be improved by increasing medical technology skills and enthusiasm of health technicians and by improving the payment policies of medical insurance funds.

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“…At present, studies mainly summarized the history and development of Chinese primary healthcare (2,3,25) , and evaluated the fairness of resource allocation and utilization of primary healthcare service. (26)(27)(28)(29)(30) However, due to the lack of support for the projects from the government, the lack of attention from researchers and other reasons, there have been few studies focusing on whether the role of primary healthcare in the overall health system is strengthened, which is the core goal of this round of health reform in China.…”

Section: Introductionmentioning

confidence: 99%

The Development Trend of Primary Healthcare after Health Reform in China

Feng

Gong

et al. 2020

Preprint

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Background: Re-constructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on whether the role of primary healthcare in the health system is strengthened in China.Methods: The data of this study came from the China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision, and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system.Results: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (P<0.001). However, compared the indicators in 2009, excepting for the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 4.04% for practicing (assistant) physicians, by 2.55% for nurses, by 4.06% for total revenues , by 5.54% for beds, by 7.37% for outpatient visits.Conclusion: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should improve the awareness of the importance of primary healthcare at all levels of local governments and ensure adequate financial input.

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Prediction and Decomposition of Efficiency Differences in Chinese Provincial Community Health Services

Cited by 26 publications

References 34 publications

Regional Differences and Influencing Factors of Allocation Efficiency of Rural Public Health Resources in China

Regional Differences and Influencing Factors of Allocation Efficiency of Rural Public Health Resources in China

The Efficiency of Primary Health Care Institutions in the Counties of Hunan Province, China: Data from 2009 to 2017

The Development Trend of Primary Healthcare after Health Reform in China

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