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Implementation efficiency of the hierarchical diagnosis and treatment system in China: A case study of primary medical and health institutions in Fujian province

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  • Qinde Wu
  • Xianyu Xie
  • Wenbin Liu
  • Yong Wu

Abstract

The hierarchical diagnosis and treatment system is at the core of China's new round of medical reforms. We evaluated the operational efficiency of the hierarchical diagnosis and treatment system in primary medical and health institutions in Fujian Province. We used the data envelopment analysis algorithm to calculate ‘input–output’ data from 2016 to 2018 and established an index system. Regarding results for efficiency value, the implementation efficiency of Xiamen was 1.15, Fuzhou was 1.10, Zhangzhou was 1.09, Ningde was 1.06, Quanzhou was 0.98, Nanping was 0.96, Putian was 0.94, Longyan was 0.92, Sanming was 0.86, and Pingtan was 0.82. There were few and insufficient doctors providing services; in 2018, the number of practicing (assistant) doctors per 1000 permanent residents in primary medical institutions in Fujian was only 0.799. Outpatient and emergency service visits were increasing yearly; in Fujian, they increased by 8.39% from 2016 to 2018. From the incentive system of hierarchical diagnosis and treatment, the redundancy rate of each city was generally high, with only that of Nanping (3.28%) and Longyan (0.00%) being lower. In general, for the hierarchical medical system to succeed, we should start with innovative management policy and explore ways to adapt to local circumstances (such as population, economy, etc.).

Suggested Citation

  • Qinde Wu & Xianyu Xie & Wenbin Liu & Yong Wu, 2022. "Implementation efficiency of the hierarchical diagnosis and treatment system in China: A case study of primary medical and health institutions in Fujian province," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 214-227, January.
    • Handle: RePEc:bla:ijhplm:v:37:y:2022:i:1:p:214-227
    DOI: 10.1002/hpm.3333
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    1. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
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    1. Fang Wu & Mingyao Gu & Chenming Zhu & Yingna Qu, 2023. "Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China," IJERPH, MDPI, vol. 20(3), pages 1-23, January.
    2. Junfang Xu & Yuyin Zhou & Ruyu Liu & Feng Cheng & Wannian Liang, 2022. "Primary Health Institutions and Service Quality in China: Implications for Health Policy," IJERPH, MDPI, vol. 19(19), pages 1-14, September.

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