Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China
Open Access
- 8 June 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal for Equity in Health
- Vol. 19 (1), 1-21
- https://doi.org/10.1186/s12939-020-01201-8
Abstract
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. Based on provincial panel data for the period of 2005 to 2017, combining expected output and unexpected output, this paper constructs a super-efficiency three-stage SBM-DEA model, to measure and analyze the spatial-temporal heterogeneity characteristics and influencing factors of public medical and health efficiency (PMHE). (1) 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. (2) The adjusted PMHE level shows a prominent spatial imbalance at the stage 3. The average efficiency level is ranked by the East > the West > the Central > the Northeast. (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 last, the urbanization level, an uncertain effect. (4) There is no σ convergence of the PMHE in the East, the Central and the West, that is, the internal differences may gradually expand in the future, while the Northeast shows a significant σ convergence trending of PMHE. (5) The state’s allocation of medical and health resources has undergone major changes during “The Twelfth Five-Year Plan”. 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 made certain achievement, it is still necessary to expand the investment in health care resources.Keywords
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Funding Information
- Ministry of Human Resources and Social Security (19YJA630103)
This publication has 42 references indexed in Scilit:
- Perceptions and Efficiency of Short-Term Medical Aid Missions Among Key Groups of Health ProfessionalsEvaluation & the Health Professions, 2012
- An epsilon-based measure of efficiency in DEA – A third pole of technical efficiencyEuropean Journal of Operational Research, 2010
- The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: A population-based investigationEconomic Modelling, 2010
- Stochastic Frontier Analysis of Hospital InefficiencyMedical Care Research and Review, 2007
- Estimation and inference in two-stage, semi-parametric models of production processesJournal of Econometrics, 2007
- A slacks-based measure of super-efficiency in data envelopment analysisEuropean Journal of Operational Research, 2002
- A slacks-based measure of efficiency in data envelopment analysisEuropean Journal of Operational Research, 2001
- Profit efficiency, Farrell decompositions and the Mahler inequalityEconomics Letters, 1997
- Productivity and Undesirable Outputs: A Directional Distance Function ApproachJournal of Environmental Management, 1997
- Measuring the efficiency of decision making unitsEuropean Journal of Operational Research, 1978