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. 2024 Jun 19:12:1366327.
doi: 10.3389/fpubh.2024.1366327. eCollection 2024.

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model

Rui Huang  1 , Wan Li  1 , Baoguo Shi  2 , Hao Su  1 , Jing Hao  1 , Chuanjun Zhao  3 , Juhong Chai  1
Affiliations

Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model

Rui Huang et al. Front Public Health. .

Abstract

Introduction: Enhancing the efficiency of primary healthcare services is essential for a populous and developing nation like China. This study offers a systematic analysis of the efficiency and spatial distribution of primary healthcare services in China. It elucidates the fundamental landscape and regional variances in efficiency, thereby furnishing a scientific foundation for enhancing service efficiency and fostering coordinated regional development.

Methods: Employs a three-stage DEA-Malmquist model to assess the efficiency of primary healthcare services across 31 provincial units in mainland China from 2012 to 2020. Additionally, it examines the spatial correlation of efficiency distribution using the Moran Index.

Results: The efficiency of primary healthcare services in China is generally suboptimal with a noticeable declining trend, highlighting significant potential for improvement in both pure technical efficiency and scale efficiency. There is a pronounced efficiency gap among provinces, yet a positive spatial correlation is evident. Regionally, efficiency ranks in the order of East > Central > West. Factors such as GDP per capita and population density positively influence efficiency enhancements, while urbanization levels and government health expenditures appear to have a detrimental impact.

Discussion: The application of the three-stage DEA-Malmquist model and the Moran Index not only expands the methodological framework for researching primary healthcare service efficiency but also provides scientifically valuable insights for enhancing the efficiency of primary healthcare services in China and other developing nations.

Keywords: China; primary healthcare; service efficiency; spatial autocorrelation; three-stage DEA-Malmquist model.

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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
Efficiency values for the first phase (2012–2020).
Figure 2
Figure 2
Comparison between stage 1 and stage 3 efficiencies (2012–2020).
Figure 3
Figure 3
Comparison between stage-1 and stage-3 efficiency in 31 provincial units.
Figure 4
Figure 4
Global Moran's I index for the PHC system (2012–2020).
Figure 5
Figure 5
LISA map of PHC system efficiency.
See this image and copyright information in PMC

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