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. 2023 Jun 15:11:1173197.
doi: 10.3389/fpubh.2023.1173197. eCollection 2023.

Estimating the efficiency of primary health care services and its determinants: evidence from provincial panel data in China

Zhe Zhao  1 , Silai Dong  2 , Jiahe Wang  1 , Qingzhi Jiang  1
Affiliations

Estimating the efficiency of primary health care services and its determinants: evidence from provincial panel data in China

Zhe Zhao et al. Front Public Health. .

Abstract

Background: The efficiency of primary health care services is drawing increased attention worldwide, especially in developing countries. Health care reform in China has moved into the 'deep water zone' phase and is facing the dilemma of inefficiency in primary health care services, which is a critical challenge for universal health coverage.

Methods: In this study, we estimate the efficiency of primary health care services in China and its determinants. A combination of a super-SBM (Slack-Based Measure) model, a Malmquist productivity index model and a Tobit model is used to study provincial panel data, and the results demonstrate the inefficiency of primary health care services in China and the variations in efficiency values between regions.

Results: Over time, the productivity of primary health care services shows a decreasing trend, mainly due to slowing technology change. Financial support is needed to improve the efficiency of primary health care services, but it is worth noting that existing social health insurance coverage decreases efficiency, while economic development, urbanization and education also have a significant impact.

Conclusion: The findings suggest that increasing financial support should remain a priority in developing countries but that reasonable reimbursement design, appropriate payment methods and comprehensive supporting social health insurance policies are key to the next step of reform.

Keywords: determinants; efficiency; financial support; primary health care services; social health insurance.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Number of PHCIs, beds and health technicians in PHCIs, 2012–2020.Source: China Health Statistical Yearbook (2013–2021).
Figure 2
Figure 2
Spatial distribution of primary health care service efficiency.
Figure 3
Figure 3
TC, TEC and TFP averages of the Malmquist Index by year.
See this image and copyright information in PMC

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