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Identifying the contribution to hospital performance among Chinese regions by an aggregate directional distance function

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  • Zhiyang Shen

    (Anhui University of Finance & Economics
    China Eximbank)

  • Vivian Valdmanis

    (Western Michigan University)

Abstract

In this paper, we examine efficiency and total factor productivity for hospitals operating in China between the years of 2009–2016. Given reforms in China focusing on the hospital sector, it has been demonstrated that efficiency and productivity are important in meeting the overall objective of meeting more accessibility to hospital care for the population. Measuring an aggregate directional distance function is in itself a non-parametric approach, we report on the decomposition of hospital performance and found that between 2009 and 2010, technical inefficiency (using resources inefficiently) dominated overall inefficiency but beyond 2011–2016, mix inefficiency (misallocation of resources) was higher. Furthermore, an additive total factor productivity (TFP) indicator is proposed to capture contributions of individual provincial (or group) hospital performance to the total productivity gain. We also report that mix inefficiency had growth throughout this time period indicating a catching up in the correct mix of inputs. This finding is worth following as hospital reform in China also focuses on utilizing the right labor and capital mix in producing efficient care.

Suggested Citation

  • Zhiyang Shen & Vivian Valdmanis, 2020. "Identifying the contribution to hospital performance among Chinese regions by an aggregate directional distance function," Health Care Management Science, Springer, vol. 23(1), pages 142-152, March.
    • Handle: RePEc:kap:hcarem:v:23:y:2020:i:1:d:10.1007_s10729-019-09482-4
    DOI: 10.1007/s10729-019-09482-4
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    1. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
    2. Boussemart, Jean-Philippe & Ferrier, Gary D. & Leleu, Hervé & Shen, Zhiyang, 2020. "An expanded decomposition of the Luenberger productivity indicator with an application to the Chinese healthcare sector," Omega, Elsevier, vol. 91(C).
    3. Li, Sung-Ko, 1995. "Relations between convexity and homogeneity in multioutput technologies," Journal of Mathematical Economics, Elsevier, vol. 24(4), pages 311-318.
    4. Yuting Zhang & Qianheng Ma & Yingchun Chen & Hongxia Gao, 2017. "Effects of Public Hospital Reform on Inpatient Expenditures in Rural China," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 421-430, April.
    5. Kerstens, Kristiaan & Shen, Zhiyang & Van de Woestyne, Ignace, 2018. "Comparing Luenberger and Luenberger-Hicks-Moorsteen productivity indicators: How well is total factor productivity approximated?," International Journal of Production Economics, Elsevier, vol. 195(C), pages 311-318.
    6. Walter Briec & Kristiaan Kerstens, 2004. "A Luenberger-Hicks-Moorsteen productivity indicator: its relation to the Hicks-Moorsteen productivity index and the Luenberger productivity indicator," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 23(4), pages 925-939, May.
    7. Boussemart, Jean Philippe & Leleu, Hervé & Shen, Zhiyang, 2015. "Environmental growth convergence among Chinese regions," China Economic Review, Elsevier, vol. 34(C), pages 1-18.
    8. H-H Hu & Q Qi & C-H Yang, 2012. "Evaluation of China's regional hospital efficiency: DEA approach with undesirable output," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 63(6), pages 715-725, June.
    9. Gary Ferrier & Hervé Leleu & Vivian Valdmanis, 2010. "The impact of CON regulation on hospital efficiency," Health Care Management Science, Springer, vol. 13(1), pages 84-100, March.
    10. Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
    11. Yang, Jinqiu & Zeng, Wu, 2014. "The trade-offs between efficiency and quality in the hospital production: Some evidence from Shenzhen, China," China Economic Review, Elsevier, vol. 31(C), pages 166-184.
    12. Hu, Hsin-Hui & Qi, Qinghui & Yang, Chih-Hai, 2012. "Analysis of hospital technical efficiency in China: Effect of health insurance reform," China Economic Review, Elsevier, vol. 23(4), pages 865-877.
    13. Chambers, Robert G. & Chung, Yangho & Fare, Rolf, 1996. "Benefit and Distance Functions," Journal of Economic Theory, Elsevier, vol. 70(2), pages 407-419, August.
    14. Kejia Chu & Ning Zhang & Zhongfei Chen, 2015. "The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia," Sustainability, MDPI, vol. 7(10), pages 1-20, October.
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    Cited by:

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    2. Xueli Chen & Vivian Valdmanis & Tuotuo Yu, 2020. "Productivity Growth in Chinese Medical Institutions during 2009–2018," Sustainability, MDPI, vol. 12(8), pages 1-17, April.
    3. Arnaud Abad & Paola Ravelojaona & Ziyi Shen, 2022. "An exponential analysis of total factor productivity," Working Papers hal-03419905, HAL.
    4. Zhensheng Chen & Xueli Chen & Tomas Baležentis & Xiaoqing Gan & Vivian Valdmanis, 2020. "Productivity change and its driving forces in Chinese healthcare sector," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-16, December.
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    6. Färe, Rolf & Karagiannis, Giannis, 2022. "Aggregating Farrell efficiencies without value data: The case of hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).

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    More about this item

    Keywords

    China hospitals; Aggregate directional distance function; Additive Total factor productivity; China hospital productivity;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L23 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Organization of Production

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