PDF(Pubmed)
Abstract：
Environmental factors like COVID-19 can have significant impact on technical efficiency (TE) and total factor productivity (TFP) of health services provided. In this study, focusing on Maternal and Child Health (MCH) hospitals in Hubei Province of China in 2019 to 2021, we aimed to measure their TE and TFP, identify some influential environmental factors, and propose some policy recommendations. Altogether 62 secondary MCH hospitals were selected as the study sample. Four input indicators, 3 output indicators, and 4 environmental indicators were selected to analyze the panel data from 2019 to 2021. Three-stage Data Envelopment Analysis (DEA) and Malmquist Productivity Index (MPI) model were employed to estimate the TE and TFP of these hospitals. During 2019 to 2021, the inputs of the sample hospitals had increased, while the outputs had decreased. The inputs redundancy was negatively associated with birth rate, number of residents, and GDP per capita (P < .05). It was positively associated with number of COVID-19 infections (P < .05). The adjusted TE scores in 2019 to 2021 were 0.822, 0.784, and 0.803, respectively. The TFP declined in 2020 and 2021 compared to 2019, with scores being 0.845 and 0.762. The technical efficiency change (TEC) scores from 2019 to 2021 were 0.926 and 1.063. The technological change (TC) scores from 2019 to 2021 were 0.912 and 0.716. During 2019 to 2021, the operation of sample hospitals had been significantly influenced by environmental factors like COVID-19 pandemic, low birth rate, number of residents, and GDP per capita. The inputs had increased but outputs had decreased, leading to an increase in inputs redundancy and a decline in TE. The TFP showed a downward trend, with TC and SEC being the priority directions for improvement. Some recommendations are made for both hospitals and government to continuously improve the TE and TFP.
摘要：
COVID-19等环境因素会对所提供卫生服务的技术效率（TE）和全要素生产率（TFP）产生重大影响。在这项研究中,以2019年至2021年中国湖北省妇幼保健（MCH）医院为重点，我们旨在衡量其TE和TFP，找出一些有影响的环境因素，并提出了一些政策建议。共选择62家二级MCH医院作为研究样本。四个输入指标，3个输出指标，并选取4项环境指标对2019年至2021年的面板数据进行分析。采用三阶段数据包络分析（DEA）和Malmquist生产率指数（MPI）模型来估计这些医院的TE和TFP。2019年至2021年，样本医院的投入有所增加，而产出却有所下降。输入冗余与出生率负相关，居民人数,和人均国内生产总值（P<0.05）。与COVID-19感染数量呈正相关（P<0.05）。2019年至2021年调整后的TE得分分别为0.822、0.784和0.803。与2019年相比，2020年和2021年的TFP下降，得分分别为0.845和0.762。2019年至2021年的技术效率变化（TEC）得分分别为0.926和1.063。2019年至2021年的技术变革（TC）得分分别为0.912和0.716。在2019年至2021年期间，样本医院的运营受到环境因素的显著影响，如COVID-19大流行，低出生率,居民人数,人均GDP。投入增加了，但产出减少了，导致输入冗余增加和TE下降。全要素生产率呈下降趋势,TC和SEC是优先改进的方向。为医院和政府提出了一些建议，以不断改进TE和TFP。
