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. 2025 Apr 23:13:1515532.
doi: 10.3389/fpubh.2025.1515532. eCollection 2025.

Efficiency analysis of primary health care resources: DEA and Tobit regression evidence from village clinics in Jiangsu Province

Wei Jiang  1 , Boyi Yang  2 , Xiaoli Dai #  1 , Shanshan Li #  1
Affiliations

Efficiency analysis of primary health care resources: DEA and Tobit regression evidence from village clinics in Jiangsu Province

Wei Jiang et al. Front Public Health. .

Abstract

Background: Village clinics are essential for delivering primary health care in rural China, yet their resource allocation efficiency remains a concern. Many clinics face challenges such as low technical efficiency, imbalanced resource distribution, and insufficient technological progress, which may hinder the delivery of quality healthcare services.

Methods: This study evaluates the resource allocation efficiency of village clinics across 13 cities in Jiangsu Province, China, using Data Envelopment Analysis. The Malmquist Productivity Index was applied to assess efficiency changes over time, and Tobit regression was employed to identify influencing factors.

Results: The overall efficiency of village clinic resource allocation in Jiangsu Province is suboptimal. In 2022, the average technical efficiency was 0.869, with seven cities classified as inefficient. Among them, three exhibited decreasing returns to scale, while four demonstrated increasing returns to scale. Reducing the number of village clinics and health technicians while increasing medical revenue could improve efficiency. From 2015 to 2022, the average Malmquist Productivity Index was 0.96, with a significant decline of 11.6% in 2021-2022, primarily due to a 6.8% decrease in technological change. Random-effects Tobit regression revealed that population density positively correlates with technical efficiency (coefficient = 0.0014, p < 0.05), whereas per capita disposable income, healthcare fiscal expenditure, and urbanization rate showed no statistically significant effects.

Conclusion: The resource allocation efficiency of village clinics in Jiangsu Province is insufficient, with technological change being a key driver of efficiency fluctuations. Population density plays a significant role in efficiency variation. To enhance efficiency, optimizing resource allocation strategies and promoting technological advancements are essential for strengthening rural primary health care.

Keywords: Malmquist productivity index; Tobit regression; data envelopment analysis; efficiency; primary health care; village clinics.

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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.

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