Does neighbours' grass matter? Testing spatial dependent heterogeneity in technical efficiency of Italian hospitals

Measurement and characteristics of the temporal-spatial evolution of China's healthcare services efficiency

BACKGROUND

Healthcare services efficiency (HSE) is directly related to the healthcare demands of the general public and also plays an essential role in the country's coordinated economic and social development.

METHODS

In this study, the stochastic frontier approach (SFA)-Malmquist model was applied to measure the HSE of 31 Chinese provinces based on panel data from 2010-2020. Then, kernel density estimation, Markov chain, and exploratory spatial data analysis were adopted to study the temporal-spatial dynamic evolution characteristics of the HSE.

RESULTS

The study found that China's HSE showed an average value of approximately 0.841, indicating room for improvement. The HSE varied significantly across regions, presenting an "East > Central > West" distribution layout. The TFP of healthcare services in China grew by 1.6% per year, driven mainly by technological progress of 1.8% per year. The trend of the HSE shifting to a high level in China was significant, but its evolution exhibited stability of maintaining the original state, and it was harder to achieve leapfrog transfer. The temporal-spatial evolution of the HSE was also significantly affected by geospatial factors, with a clear spatial spillover effect and spatial agglomeration characteristics. Provinces with high-level HSE exhibited positive spatial spillover effects, while provinces with low-level HSE had negative spatial spillover effects. Thus, the "club convergence" phenomenon of "high efficiency concentration, low efficiency agglomeration, high levels of radiation, and low levels of suppression" was formed in the spatial distribution.

CONCLUSIONS

The results indicate that countermeasures should be taken to improve the HSE in China. Theoretical support for the improvement of HSE is provided in this paper.

Do China rural traditional Chinese medicine hospitals provide efficient healthcare to the people? Empirical study from 2013 to 2018 using data envelopment analysis

Rural traditional Chinese medicine hospitals bear responsibilities of providing efficient medical services for rural residents. Efficiency assessments have previously been conducted in single province. This study aimed to investigate the technical efficiency of rural traditional Chinese medicine hospitals across China from 2013 to 2018, with the application of super slack-based measure data envelopment analysis. In total, 1219 hospitals covering 28 provinces were included as sample hospitals. Overall, hospitals performed technically less efficiently but presented with an increasing trend. Redundancy and insufficiency existed in health input and output variables, respectively. Notably, optimizing input variables was found to make more substantial improvement in hospital efficiency. Provincial and regional disparities were also observed in hospital efficiency. In conclusion, rural traditional Chinese medicine hospitals have experienced slight improvement in efficiency during the study period, however, their efficiency was still in a relatively low level with ample room for improvement. Meanwhile, regional coordinated development should also be noticed in this process.

Exploring hospital efficiency within and between Italian regions: new empirical evidence

This paper investigates the efficiency of Italian hospitals and how their performances have changed over the years 2007-2016, characterized by the great economic recession and budget constraints. We apply the Benefit of Doubt (BoD) approach to determine a composite index that considers the multi-dimensionality of the hospital outcome to be used as main output in a metafrontier production function based on a stochastic frontier framework. The efficiency score distribution is then used to construct a Theil index in order to compare, over time, the inequality of the estimated efficiency between hospitals, both within and between regions. The main findings show that the primary source of inefficiency comes from managerial inefficiency especially for hospitals located in southern regions. A clear and persistent North-South gap in efficiency performances of hospitals has been found along with an increase in the inequality in terms of efficiency between the areas of the country mostly determined by between region inequality.