-
Tytuł:
-
Efficiency of health resource utilisation in primary-level maternal and child health hospitals in Shanxi Province, China: a bootstrapping data envelopment analysis and truncated regression approach.
-
Autorzy:
-
Zhang T; Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13, Aviation Road, Qiaokou District, Wuhan, Hubei Province, China.
Lu W; Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13, Aviation Road, Qiaokou District, Wuhan, Hubei Province, China. .
Tao H; Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13, Aviation Road, Qiaokou District, Wuhan, Hubei Province, China.
-
Źródło:
-
BMC health services research [BMC Health Serv Res] 2020 Mar 06; Vol. 20 (1), pp. 179. Date of Electronic Publication: 2020 Mar 06.
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: London : BioMed Central, [2001-
-
MeSH Terms:
-
Efficiency, Organizational/*statistics & numerical data
Health Resources/*statistics & numerical data
Hospitals, Maternity/*organization & administration
Hospitals, Pediatric/*organization & administration
Primary Health Care/*organization & administration
Child ; China ; Data Interpretation, Statistical ; Female ; Hospitals, County/organization & administration ; Hospitals, District/organization & administration ; Humans ; Pregnancy ; Regression Analysis
-
References:
-
Int J Equity Health. 2017 Mar 3;16(1):42. (PMID: 28253876)
BMJ Open. 2015 Sep 09;5(9):e007267. (PMID: 26353864)
Lancet. 2016 Oct 15;388(10054):1930-1938. (PMID: 27751400)
Eur J Health Econ. 2013 Dec;14(6):979-94. (PMID: 23229820)
Semin Fetal Neonatal Med. 2015 Oct;20(5):309-14. (PMID: 26271835)
BMC Health Serv Res. 2014 Apr 06;14:158. (PMID: 24708701)
Lancet. 2006 Oct 28;368(9546):1474-7. (PMID: 17071267)
Trop Med Int Health. 2012 Dec;17(12):1441-8. (PMID: 22994293)
Int J Health Policy Manag. 2014 Jun 08;3(2):63-9. (PMID: 25114944)
BMC Health Serv Res. 2013 Aug 15;13:312. (PMID: 23945011)
Int J Equity Health. 2017 Apr 20;16(1):66. (PMID: 28427423)
Int J Equity Health. 2016 Aug 23;15(1):131. (PMID: 27552805)
BMJ Open. 2016 Nov 11;6(11):e011911. (PMID: 27836870)
Hum Resour Health. 2016 Sep 20;14(1):55. (PMID: 27649794)
Inquiry. 2015 Sep 21;52:. (PMID: 26396090)
BMC Health Serv Res. 2015 Dec 16;15:561. (PMID: 26674783)
BMC Health Serv Res. 2016 Jul 08;16:230. (PMID: 27391312)
Lancet. 2011 Sep 24;378(9797):1139-65. (PMID: 21937100)
Paediatr Int Child Health. 2014 Aug;34(3):156-64. (PMID: 24621235)
Hum Resour Health. 2018 Feb 20;16(1):13. (PMID: 29463253)
-
Grant Information:
-
71774061 National Natural Science Foundation of China
-
Contributed Indexing:
-
Keywords: China; Data envelopment analysis; Maternal and child health hospital; Technical efficiency; Truncated regression
-
Entry Date(s):
-
Date Created: 20200308 Date Completed: 20201113 Latest Revision: 20201113
-
Update Code:
-
20240105
-
PubMed Central ID:
-
PMC7059375
-
DOI:
-
10.1186/s12913-020-5032-y
-
PMID:
-
32143651
-
Background: District- and county-level maternal and child health hospitals (MCHHs) are positioned to provide primary maternal and child healthcare in rural and urban areas of China. Their efficiencies and productivity largely affect the equity and accessibility of maternal and child health care. This study aimed to assess the efficiency of district- and county-level MCHHs in China and identify their associated factors.
Methods: Thirty-three district- and 84 county-level MCHHs were selected from Shanxi Province in 2017. At the first stage, bootstrapping data envelopment analysis (DEA) models were established to calculate the technical efficiency (TE), pure technical efficiency (PTE) and scale efficiency (SE) of district- and county-level hospitals. At the second stage, the estimated efficiency scores were regressed against external and internal hospital environmental factors by using bootstrap truncated regression to identify their determinants.
Results: The average TE, PTE and SE scores for district-level MCHHs were 0.7433, 0.8633 and 0.9335, respectively. All hospitals were found to be weakly efficient, although more than 50% of the hospitals performed with efficient SE (SE scores≥100%). As for county-level MCHHs, their average TE, PTE and SE scores were 0.5483, 0.6081 and 0.9329, respectively. The hospitals with TE and PTE scores less than 0.7 accounted for more than 60%, and no hospital was observed to operate effectively. Truncated regressions suggested that the proportion of health professionals, including doctors, nurses, pharmacists, inspection technician and image technician (district level: β = 0.57, 95% CI = 0.30-0.85; county level: β = 0.33, 95% CI = 0.15-0.52), and the number of health workers who received job training (district level: β = 0.67, 95% CI = 0.26-1.08; county level: β = 0.34, 95% CI = 0.14-0.54) had a positive association with efficiency scores. The amount of financial subsidy (β = 0.07, 95% CI = 0.05-0.09) was found to be directly proportional to the productive efficiency of the county-level MCHHs.
Conclusion: The operational inefficiency of district- and county-level MCHHs in Shanxi Province is severe and needs to be substantially improved, especially in terms of TE and PTE. Hiring additional medical personnel and ensuring the stability of the workforce should be prioritised. The Chinese government must provide sufficient financial subsidy to compensate for service costs.
Zaloguj się, aby uzyskać dostęp do pełnego tekstu.