Background
Methods
A review of approach
Instruments
Category | Variables | Definition |
---|---|---|
Inputs | Actual number of open beds | The number of available bed days divided by the number of days in a year |
Number of employees | Registered employees at the end of year, excluding retirees and temporary staff | |
Fixed assets | Tangible assets having been used more than one year with values amounting to specific standards and with their original physical attributes not changed | |
Total expenditure | Capital consumption and loss in the process of service provision and other activities, including healthcare expenditure, drug and medicine expenditure, special financial expenditure, etc. | |
Outputs | Number of outpatient and emergency visits | The number of patients coming for outpatient and emergency diagnostic services |
Number of discharged patients | The number of discharged patients after hospitalization for various reasons | |
Total revenue | Revenue gained from service provision and other activities, including healthcare revenue, drug and medicine sales, financial subsidies, health administrative department subsidies, etc. |
Data source and sample
Data processing and analysis
Results
Descriptive statistics and analysis
No. | Input and output variables | 2006 | 2007 | 2008 | 2009 | Growth rates |
---|---|---|---|---|---|---|
1 | Actual number of open beds | 1187 | 1187 | 1249 | 1280 | 7.83% |
2 | Number of employees | 2642 | 2778 | 2968 | 2939 | 11.24% |
3 | Fixed asset | 92135 | 101988 | 113190 | 120400 | 30.68% |
4 | Total expenditure | 90296 | 116934 | 112169 | 116928 | 29.49% |
5 | Number of outpatient and emergency visits | 1210433 | 1456612 | 1615103 | 1721248 | 42.20% |
6 | Number of discharged patients | 30099 | 32648 | 36059 | 39579 | 31.50% |
7 | Total revenue | 88970 | 118321 | 141699 | 148283 | 66.67% |
8 | Bed occupancy rate | 0.94 | 0.97 | 0.95 | 0.95 | 1.06% |
9 | Average length of stay in hospital | 13.4 | 12.9 | 12.1 | 11.3 | -15.67% |
Malmquist index analysis
TFP Changes
Technological changes
Technical efficiency changes
Discussion
Technological changes
Technical efficiency changes
Allocative efficiency
The need for multi-dimensional performance evaluation
Limitations and further development
-
This research has some limitations. The first one is the limited number of hospitals available for the research. In further research design, the sample can be extended to include all three grades of hospitals in Beijing or in another region, with respective efficiency and productivity analysis for comparison. In this way, the flow of healthcare resources among the three types of hospitals would be much clearer, which would be helpful to identify weakness of hospital system for further improvements in efficiency and productivity.
-
In our study, bias adjustments of efficiency scores were not conducted due to limitation of Coelli’s approach. In future research, a Bootstrap-Malmquist approach can be applied for more exact results.
-
Coelli and Rao [40] pointed out that in Malmquist DEA, the explicit price information is replaced by implicit (or shadow) price information. These implicit prices may differ substantially from market prices, thus result in TFP measures that may differ substantially from those obtained using other methods. Furthermore, the piece-wise linear nature of the DEA surface (and the regular occurrence of slack regions) can result in wide variations in shadow prices, which subsequently lead to significant differences in the weights assigned to different inputs across the sample. Therefore, in future research, alternative methods are encouraged to be applied for robustness check.