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Study on the operational efficiency and variation trend of municipal-level public hospitals in Chongqing based on DEA and SFA analyses

ZHENG Wan-hui1, 2, LONG Chang1,3, SUN Hong3   

  1. 1. Xiangya School of Public Health, Central South University, Changsha 410011,China; 2. The Ninth People’s Hospital of Chongqing, Chongqing 400700, China; 3. Xiangya Hospital, Central South University, Changsha 410008, China
  • Online:2016-12-28 Published:2016-12-29
  • Supported by:

    National Social Sciences Fund of China, 14BGL112; College Humanities and Social Science Research Program of Chongqing, 16SKGH019)；Chongqing Beibei District Science & Technology Commission, 2016-36; Bidding Project of Chongqing Institute of Health Economics, YWJK2016-9

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Abstract:

Objective · To explore the operational efficiency and the variation trend of 16 municipal-level public hospitals in Chongqing after the new health care reform and to provide quantitative evidence for overall advance of urban public hospital reform in 2017. Methods · Data of main business indicators from 16 public hospitals (2009-2015) were collected. The mean and sample values of overall efficiency, pure technical efficiency, and scale efficiency were calculated with a BC2 model of the data envelopment analysis (DEA) and the input redundancy and output deficit were analyzed. The mean and sample values of productivity and cost effectiveness were calculated using the Cobb-Douglas production model of the stochastic frontier approach (SFA). The values were verified with the maximum likelihood method. The effects of productivity and cost effectiveness on total output and total cost were determined according to coefficients. Results · DEA analysis showed that average overall efficiency, pure technical efficiency, and scale efficiency were efficient in 16 public hospitals (0.852-0.991), but the optimal value (1.000) for above 3 indicators was only obtained in 3 public hospitals. There were irregular differences in the above 3
indicators, as well as input redundancy and output deficit. SFA analysis showed that the average cost-effectiveness was efficient in 16 public hospitals (0.8891.000), while the average productivity was moderate to efficient (0.665-0.782) with large differences among the hospitals. Some indicators negatively influenced the productivity, including the number of outpatients and emergency patients, actual available bed days, and fixed assets medical income per
hundred yuan. Conclusion · The government should pay more attention to efficiency estimation and variation trend, reasonably solve problems in allocating limited medical resources, and enhance the effect of efficiency in quantitative input when evaluating the public hospitals.

Key words: municipal-level public hospitals, operating efficiency, development trend, data envelopment analysis, stochastic frontier approach