IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i21p13831-d951850.html
   My bibliography  Save this article

Analysis of the Operational Efficiency of Basic Medical Insurance for Urban and Rural Residents: Based on a Three-Stage DEA Model

Author

Listed:
  • Tong Liu

    (Health Management College, Anhui Medical University, Hefei 230032, China)

  • Yufei Gao

    (Health Management College, Anhui Medical University, Hefei 230032, China)

  • Hui Li

    (Health Management College, Anhui Medical University, Hefei 230032, China)

  • Liping Zhang

    (School of Marxism, Anhui Medical University, Hefei 230032, China)

  • Jiangjie Sun

    (Health Management College, Anhui Medical University, Hefei 230032, China)

Abstract

Following the integration of the urban residents’ medical insurance into the new rural cooperative medical insurance in 2016, China has now formed a basic medical insurance system with the urban workers’ basic medical insurance system and the rural residents’ basic medical insurance system as the main entities. With the development of basic medical insurance, the protection for residents is becoming more and more comprehensive, and its fund expenditure also increases, so it is necessary to research the efficiency of the medical insurance fund expenditure. This paper conducts a three-stage DEA analysis of the efficiency of basic health insurance for urban and rural residents in 31 provinces, based on a Chinese panel data from 2017 to 2020. It is found that China’s health insurance operation is still in the development stage, with four regions in the efficiency frontier and Guizhou province having the lowest efficiency value nationwide. The GDP and fiscal investment on social security effectively reduce the input redundancy in the basic health insurance operation, which contributes to the efficiency of the health insurance operation. This study further proposes suggestions and countermeasures to improve the operational efficiency of China’s basic health insurance, based on the empirical results: (1) develop the economy and broaden the financing sources; (2) improve the level of health care services and improve the efficiency driven by quality; and (3) improve the level of health insurance supervision through multiple measures.

Suggested Citation

  • Tong Liu & Yufei Gao & Hui Li & Liping Zhang & Jiangjie Sun, 2022. "Analysis of the Operational Efficiency of Basic Medical Insurance for Urban and Rural Residents: Based on a Three-Stage DEA Model," IJERPH, MDPI, vol. 19(21), pages 1-20, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13831-:d:951850
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/21/13831/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/19/21/13831/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Limei Jing & Ru Chen & Lisa Jing & Yun Qiao & Jiquan Lou & Jing Xu & Junwei Wang & Wen Chen & Xiaoming Sun, 2017. "Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(3), pages 285-298, July.
    2. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    3. H. Fried & C. Lovell & S. Schmidt & S. Yaisawarng, 2002. "Accounting for Environmental Effects and Statistical Noise in Data Envelopment Analysis," Journal of Productivity Analysis, Springer, vol. 17(1), pages 157-174, January.
    4. Jondrow, James & Knox Lovell, C. A. & Materov, Ivan S. & Schmidt, Peter, 1982. "On the estimation of technical inefficiency in the stochastic frontier production function model," Journal of Econometrics, Elsevier, vol. 19(2-3), pages 233-238, August.
    5. Patrick L. Brockett & Linda L. Golden & Charles C. Yang, 2018. "Potential “Savings” of Medicare: The Analysis of Medicare Advantage and Accountable Care Organizations," North American Actuarial Journal, Taylor & Francis Journals, vol. 22(3), pages 458-472, July.
    6. Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
    7. Martine Audibert & Jacky Mathonnat & Aurore Pelissier & Xiao Xian Huang & Anning Ma, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," Post-Print halshs-01230210, HAL.
    8. Patrick L. Brockett & Ray E. Chang & John J. Rousseau & John H. Semple & Chuanhou Yang, 2004. "A Comparison of HMO Efficiencies as a Function of Provider Autonomy," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 71(1), pages 1-19, March.
    9. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    10. Park, Jun-ki & Ryu, Deockhyun & Lee, Keun, 2019. "What determines the economic size of a nation in the world: Determinants of a nation’s share in world GDP vs. per capita GDP," Structural Change and Economic Dynamics, Elsevier, vol. 51(C), pages 203-214.
    11. Victor Ngobeni & Marthinus C. Breitenbach & Goodness C. Aye, 2020. "Technical Efficiency of Provincial Public Healthcare in South Africa," Working Papers 202013, University of Pretoria, Department of Economics.
    12. Charnes, A. & Cooper, W. W. & Rhodes, E., 1979. "Measuring the efficiency of decision-making units," European Journal of Operational Research, Elsevier, vol. 3(4), pages 339-338, July.
    13. Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Zhongwu Zhang & Jinyuan Zhang & Liping Liu & Jian Gong & Jinqiang Li & Lei Kang, 2023. "Spatial–Temporal Heterogeneity of Urbanization and Ecosystem Services in the Yellow River Basin," Sustainability, MDPI, vol. 15(4), pages 1-20, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carla Henriques & Clara Viseu, 2022. "Are ERDFs Devoted to Boosting ICTs in SMEs Inefficient? A Three-Stage SBM Approach," Sustainability, MDPI, vol. 14(17), pages 1-20, August.
    2. Avkiran, Necmi K. & Rowlands, Terry, 2008. "How to better identify the true managerial performance: State of the art using DEA," Omega, Elsevier, vol. 36(2), pages 317-324, April.
    3. Vaninsky, Alexander, 2010. "Prospective national and regional environmental performance: Boundary estimations using a combined data envelopment – stochastic frontier analysis approach," Energy, Elsevier, vol. 35(9), pages 3657-3665.
    4. David C. Wheelock & Paul W. Wilson, 2000. "Why do Banks Disappear? The Determinants of U.S. Bank Failures and Acquisitions," The Review of Economics and Statistics, MIT Press, vol. 82(1), pages 127-138, February.
    5. Meng Ye & Yanan Jin & Fumin Deng, 2022. "Municipal waste treatment efficiency in 29 OECD countries using three-stage Bootstrap-DEA model," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 24(9), pages 11369-11391, September.
    6. A. M. Theodoridis & A. Psychoudakis, 2008. "Efficiency Measurement in Greek Dairy Farms: Stochastic Frontier vs. Data Envelopment Analysis," International Journal of Business and Economic Sciences Applied Research (IJBESAR), International Hellenic University (IHU), Kavala Campus, Greece (formerly Eastern Macedonia and Thrace Institute of Technology - EMaTTech), vol. 1(2), pages 53-67, December.
    7. Boutheina Bannour & Asma Sghaier & Mohammad Nurunnabi, 2020. "How to Choose a Nonparametric Frontier Model? Technical Efficiency of Turkish Banks Assessing Global," Global Business Review, International Management Institute, vol. 21(2), pages 348-364, April.
    8. Johnes, Jill, 2015. "Operational Research in education," European Journal of Operational Research, Elsevier, vol. 243(3), pages 683-696.
    9. Jie Wu & Ganggang Zhang & Qingyuan Zhu & Zhixiang Zhou, 2020. "An efficiency analysis of higher education institutions in China from a regional perspective considering the external environmental impact," Scientometrics, Springer;Akadémiai Kiadó, vol. 122(1), pages 57-70, January.
    10. Mai, Nhat Chi, 2015. "Efficiency of the banking system in Vietnam under financial liberalization," OSF Preprints qsf6d, Center for Open Science.
    11. Zeng, Shihong & Jiang, Chunxia & Ma, Chen & Su, Bin, 2018. "Investment efficiency of the new energy industry in China," Energy Economics, Elsevier, vol. 70(C), pages 536-544.
    12. Barros, Carlos Pestana & Williams, Jonathan, 2013. "The random parameters stochastic frontier cost function and the effectiveness of public policy: Evidence from bank restructuring in Mexico," International Review of Financial Analysis, Elsevier, vol. 30(C), pages 98-108.
    13. Badunenko, Oleg & Galeotti, Marzio & Hunt, Lester C., 2021. "Better to grow or better to improve? Measuring environmental efficiency in OECD countries with a Stochastic Environmental Kuznets Frontier," FEEM Working Papers 316226, Fondazione Eni Enrico Mattei (FEEM).
    14. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    15. Ahn, Heinz & Clermont, Marcel & Langner, Julia, 2023. "Comparative performance analysis of frontier-based efficiency measurement methods – A Monte Carlo simulation," European Journal of Operational Research, Elsevier, vol. 307(1), pages 294-312.
    16. Henderson, Benjamin B. & Kingwell, Ross S., 2001. "An Investigation of the Technical and Allocative Efficiency of Broadacre Farmers," 2002 Conference (46th), February 13-15, 2002, Canberra, Australia 125109, Australian Agricultural and Resource Economics Society.
    17. Angela Stefania Bergantino & Enrico Musso, 2011. "A Multi-step Approach to Model the Relative Efficiency of European Ports: The Role of Regulation and Other Non-discretionary Factors," Chapters, in: Kevin Cullinane (ed.), International Handbook of Maritime Economics, chapter 18, Edward Elgar Publishing.
    18. W. Cooper & C. Lovell, 2011. "History lessons," Journal of Productivity Analysis, Springer, vol. 36(2), pages 193-200, October.
    19. Frederick, Joshua D. & Fung, Derrick W.H. & Yang, Charles C. & Yeh, Jason J.H., 2022. "Individual health insurance reforms in the U.S.: Expanding interstate markets, Medicare for all, or Medicaid for all?," European Journal of Operational Research, Elsevier, vol. 297(2), pages 753-765.
    20. Pengyu Ren & Zhaoxia Liu, 2021. "Efficiency Evaluation of China’s Public Sports Services: A Three-Stage DEA Model," IJERPH, MDPI, vol. 18(20), pages 1-12, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13831-:d:951850. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.