Bootstrapping data envelopment analysis of efficiency and productivity of county public hospitals in Eastern, Central, and Western China after the public hospital reform

2017 ◽  
Vol 37 (5) ◽  
pp. 681-692 ◽  
Author(s):  
Man-li Wang ◽  
Hai-qing Fang ◽  
Hong-bing Tao ◽  
Zhao-hui Cheng ◽  
Xiao-jun Lin ◽  
...  
Keyword(s):  
Data Envelopment Analysis ◽  
Public Hospital ◽  
Public Hospitals ◽  
Western China ◽  
Data Envelopment ◽  
The Public ◽  
Hospital Reform ◽  
Efficiency And Productivity ◽  
Public Hospital Reform

Influence of Web Application Technology on the Public Hospital Reform in China

2013 ◽  
Vol 859 ◽  
pp. 613-618
Author(s):  
Qian Ran He ◽  
Mi Hua Xian
Keyword(s):  
Web Application ◽  
Public Hospital ◽  
Public Hospitals ◽  
Application Technology ◽  
Role Of Government ◽  
The Public ◽  
Hospital Reform ◽  
Internal And External Factors ◽  
Public Hospital Reform

Web application technology is system which is linked with each other by many hypertext systems, through the Internet access and plays an important role in public hospital reform. Public hospital reformist carried out in the complicated political and economic environment and will be affected and restricted by internal and external factors. On the macro, the role of government, guiding theories of reform, value orientation, economic and technical factors and so on engender a significant influence on the reform; on the micro, the interest game between stakeholders of public hospital also affects the implementation of the reform of public hospitals

scholarly journals Longitudinal Evaluation on the Operation Index Applied to Public Hospitals in Pudong New District of Shanghai, China

2018 ◽  
Vol 55 ◽  
pp. 004695801879059
Author(s):  
Shanshan Liu ◽  
Jiaoling Huang ◽  
Yanting Li ◽  
Jincheng Fan ◽  
Hong Liang ◽  
...  
Keyword(s):  
Financial Risk ◽  
Public Hospital ◽  
Risk Index ◽  
Condition Index ◽  
Public Hospitals ◽  
Operating Index ◽  
The Public ◽  
Management Condition ◽  
Service Operation ◽  
Public Hospital Reform

The public hospital reform has lasted 5 years in China; however, the operation development status and trends of public hospitals have not been systematically evaluated in Pudong New District. We first applied the technology of longitudinal index to assess the development of public hospitals there. The quantitative data were mainly gathered by taking health statistics database from 2009 to 2014. The results showed that overall operating index presented a down-up trend, with the highest point in 2014 and the lowest point in 2012. Overall operating index, development foundation index, and management condition index were found to be statistically different ( P = .010, P = .016, P = .031) in different years, whereas the service operation index and financial risk index were not so ( P = .543, P = .228). Moreover, the results demonstrated that no obvious difference was observed in the overall operating index between the general and specialized hospitals ( P = .327), which was the same in the 4 first-class indexes. However, there were statistical differences in the overall operating index and development foundation index among these 5 years ( P = .018, P = .036), but none in the service operation index, management condition index, and financial risk index ( P = .503, P = .062, P = .177). No interaction effects were discovered between year and hospital categories in the current study ( P = .673, P = .375, P = .885, P = .152, P = .288).

scholarly journals Have the Pilot County Hospitals’ Service Capability Been Improved Since the Healthcare Reform? An Analysis of 370 Hospitals in China

2019 ◽  
Author(s):  
Yinhong Dong ◽  
Xingyi YANG ◽  
Pengqian FANG ◽  
Zhengqiong PAN ◽  
Zhenni LUO
Keyword(s):  
Public Hospital ◽  
Healthcare Reform ◽  
Current Situation ◽  
Public Hospitals ◽  
Analysis Method ◽  
Hospital Reform ◽  
Comprehensive Service ◽  
Service Capability ◽  
Public Hospital Reform ◽  
Better Than

Background: County public hospital reform is one of the major tasks proposed in Chinese Healthcare Reform., and the evaluation of hospital reform effectiveness is very important and beneficial since it helps the government to understand the current situation of pilot county public hospitals and smoothly start the reform in all county hospitals. Methods: This study used hospitals data from 2009 to 2012 to evaluate the effectiveness of county public hospital reform through comprehensive service capability. Descriptive analysis method was used, and factor analysis method was used to extract the main factors associated with service capabilities as well as to calculate a composite score. The t-test of two independent-samples methods was used to comparison analyze. Results: The differences of common factor scores (hospital scale and service capacity, treatment quality, service quality, and services efficiency) between pilot and non-pilot hospitals were not statistically significant (P>0.05). The service capability score in 2012 was better than that in 2009 either in pilot or non-pilot group (P<0.05). The pilot hospitals’ service capability score was better than that in non-pilot groups either in 2010 or 2012 (P<0.05). However, the differences from 2009 to 2012 of service capability score between pilot and non-pilot hospitals were not statistically significant. Conclusion: The comprehensive service capability of both pilot and non-pilot group all got improvement. However, county public hospital reform did not significantly play a due good role in improving the service capability in pilot group. The reform was helpful to improve the hospital current situation, but it has not completely achieved policy objectives in the sample hospitals of this study.

scholarly journals Measuring Efficiency of Public Hospitals in Iran: A Comparative Study Using Extended Data Envelopment Analysis, 2012-2016

2020 ◽  
Author(s):  
Efat Mohamadi ◽  
Amirhossein Takian ◽  
Alireza Olyaee Manesh ◽  
Reza Majdzadeh ◽  
Farhad Hosseinzadeh Lotfi ◽  
...  
Keyword(s):  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Public Hospitals ◽  
Malmquist Productivity Index ◽  
Productivity Index ◽  
Data Envelopment ◽  
Use Of Resources ◽  
District Hospitals ◽  
Geographical Regions ◽  
Efficiency And Productivity

Abstract Background: Aiming to enhance quality of care and increase efficiency, public hospitals have undergone several reforms in the course of last two decades in Iran. This paper reports the result of a national research that aimed to measure the technical efficiency and productivity change of public hospitals during 2012-2016 in Iran. Methods: We used Extended Data Envelopment Analysis (Extended-DEA) (an innovative modification to conventional DEA) to measure technical efficiency and productivity of 568 public hospitals. Nationally representative data were extracted from the official annual health reports. Data were analysed using GAMS software 24.3. Results: The average efficiency score of all hospitals was 0.733. 10.1% of all hospitals were efficient while 2.68% of them were under 0.2. The Malmquist Productivity Index (MPI) progressed in 49.3% of hospitals, remained constant in 2.3%, while 48.2% of hospitals regressed during 2015-2016. The average of MPI was 1.07 over the period of analysis. Conclusions: Extra efforts seem to be essential to enhance the efficient use of resources and develop appropriate policy solutions and tools. In particular, to increase the return to scale, we advocate the merger of small-size district hospitals towards establishing bigger efficient hospitals in various geographical regions across the country.

scholarly journals The Effects of County Public Hospital Reform on the Consumption and Costs of Antibiotics: Evidence from a Quasinatural Experiment in Jiangsu, China

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Ying Wang ◽  
Yulei Zhu ◽  
Xiaoliang Liu ◽  
Xinglu Xu ◽  
Wenqing Fang ◽  
...  
Keyword(s):  
Public Hospital ◽  
Intervention Group ◽  
Jiangsu Province ◽  
Public Hospitals ◽  
Control Group ◽  
Chinese Government ◽  
Oral Antibiotics ◽  
Average Volume ◽  
Hospital Reform ◽  
Public Hospital Reform

Background. Overuse of antibiotics is a major driver for rapid spread of antimicrobial resistance worldwide, particularly common in China. The close linkage between hospital revenue and sales of drugs has become the key incentive for overprescription of antibiotics. Since 2009, the Chinese government implemented a series of measures to cut off the link, including removing the markup of drugs, increasing financial subsidies, and adjusting charges for medical service. Objective. To evaluate the impacts of county public hospital reform on the consumption and costs of procured antibiotics in Jiangsu province. Methods. A quasiexperiment design was conducted in Jiangsu province where 99 county public hospitals implemented the reform successively in different periods. Of these, 37 county public hospitals implemented the reform since January 2013, which were regarded as the intervention group, and the remaining 62 hospitals were included in the control group. A difference-in-differences (DID) analysis with generalized linear regressions was used on the procurement records of antibiotics from January 2012 to December 2013. Modified Park test was used for family distribution and Box–Cox test for log link. Placebo tests were employed to test the common-trend hypothesis of two groups. Results. For the intervention group, the average volume of procured restricted antibiotics and injectable antibiotics increased by 24.12% and 2.75% while the costs increased by 19.01% and 9.09%, respectively. The average costs per DDD of restricted and injectable antibiotics were much higher than unrestricted and oral antibiotics. The DID results showed that the reform had a positive impact on the average volume ( p = 0.005 ) and costs ( p = 0.001 ) of nonrestricted antibiotics. In addition, the implementation of the reform was associated with a reduction in volume ( p = 0.031 ) and costs ( p = 0.043 ) of procured oral antibiotics. The reform also contributed to an increase in average costs per DDD of total antibiotics ( p = 0.049 ). Conclusions. The reform is effective in reducing the consumption and costs of unrestricted and oral antibiotics, but it has failed to reduce the consumption and costs of expensive restricted and injectable antibiotics, leading to increased burden of diseases. It is critical that the health policy initiatives can deincentivize overuse of antibiotics at both hospital and individual physician’s levels. The reform should enforce government financial support, improve hospital governance, optimize performance evaluation, and establish specialized management approach for antibiotic use.

scholarly journals Efficiency Comparison of Public Hospitals under Different Administrative Affiliations in China: A Pilot City Case

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 437
Author(s):  
Gang Yin ◽  
Chaoyi Chen ◽  
Lijun Zhuo ◽  
Qingjing He ◽  
Hongbing Tao
Keyword(s):  
Public Hospital ◽  
Malmquist Index ◽  
Public Hospitals ◽  
Central China ◽  
Productivity Change ◽  
Data Envelopment ◽  
Evolution Analysis ◽  
Efficiency Comparison ◽  
Test Robustness ◽  
Public Hospital Reform

This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.

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