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The trade-offs between efficiency and quality in the hospital production: Some evidence from Shenzhen, China

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  • Yang, Jinqiu
  • Zeng, Wu

Abstract

This study aims to examine the trends of productivity, efficiency and quality changes of hospitals in Shenzhen city over the period 2006–2010 and explore whether there is a trade-off between efficiency and quality in the hospital production. A three-stage data envelopment analysis (DEA) based Malmquist productivity index is used to estimate the changes of productivity, efficiency and quality. The results show that both public and private hospitals have experienced a productivity growth and a negative evolution in efficiency and quality changes between 2006 and 2010. The average annual productivity growth rates of public and private hospitals are 4.1% and 2.8% respectively; the average annual reduction rates of efficiency are 1.8% and 1.2% respectively; the quality declines on average by 2.5% and 7.2% per year respectively. We may not rule out the existence of efficiency and quality trade-off in our study. This possible trade-off is mainly found in the small and medium-sized hospitals. Our results are robust when varying the specification of the DEA model.

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  • 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.
    • Handle: RePEc:eee:chieco:v:31:y:2014:i:c:p:166-184
    DOI: 10.1016/j.chieco.2014.09.005
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    9. Ferreira, D.C. & Marques, R.C., 2019. "Do quality and access to hospital services impact on their technical efficiency?," Omega, Elsevier, vol. 86(C), pages 218-236.
    10. Zhang, Cai Wen & Yang, Yuanhui, 2023. "Appraisal of regional hospital efficiency and healthcare quality in China: Impacts of subsidies and marketization," Socio-Economic Planning Sciences, Elsevier, vol. 89(C).
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    14. Wasim Sultan & José Crispim, 2016. "Evaluating the Productive Efficiency of Jordanian Public Hospitals," International Journal of Business and Management, Canadian Center of Science and Education, vol. 12(1), pages 1-68, December.
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    17. 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.
    18. Guccio, C. & Lisi, D. & Martorana, M.F. & Pignataro, G., 2020. "Incorporating quality in the efficiency assessment of hospitals using a generalized directional distance function approach," Health, Econometrics and Data Group (HEDG) Working Papers 20/17, HEDG, c/o Department of Economics, University of York.
    19. Huang, Fei & Zhou, Dequn & Hu, Jin-Li & Wang, Qunwei, 2020. "Integrated airline productivity performance evaluation with CO2 emissions and flight delays," Journal of Air Transport Management, Elsevier, vol. 84(C).
    20. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    21. Kuan-Chen Chen & Hong-Ming Chen & Li-Nien Chien & Ming-Miin Yu, 2019. "Productivity growth and quality changes of hospitals in Taiwan: does ownership matter?," Health Care Management Science, Springer, vol. 22(3), pages 451-461, September.
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    23. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.

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