The Productive Efficiency of Health care Institutions …：医疗保健机构的生产效率….pptVIP

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The Productive Efficiency of Health care Institutions …：医疗保健机构的生产效率….ppt

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The Productive Efficiency of Health care Institutions …：医疗保健机构的生产效率…

The Productive Efficiency of Health Care Institutions: An Application of Chinese Hospitals Ying Chu NG Department of Economics Hong Kong Baptist University Hong Kong, CHINA Presented at The 7th International Conference on Data Envelopment Analysis Fox School of Business, Temple University Philadelphia, PA, USA July 10-12, 2009 Background National expenditure on health care in China has been increasing over the years: 3.17% of GDP in 1980; 3.86% of GDP in 1995; 5.5% of GDP in 2004 Decline in government’s contribution to health care provision: 30% in the late 1980s to 15% in 2002 Rise in individual’s out-of-pocket health care payment: 21% in 1990 to 50% in 2006 Background Health care reform since mid 1980s Fall in government subsidies Greater autonomy to generate, retain and manage surplus revenue of health care providers Over-prescribing drugs and tests; adopting high-tech medical treatments (drug sales contribute nearly 50% of hospitals’ income) Improvement in efficiency and quality induced by market and economic incentives may be undermined by revenue generation imperative Objectives How efficient are Chinese hospitals in the post-reform period? Any change in the productivity of Chinese hospitals? DEA efficiency measures and Malmquist Indices Hospital Efficiency and Productivity Growth See review studies by Hollingsworth (2003, 2008) Worthington (2004) O’Neill, Rauner, Heidenberger and Kraus (2008) Emrouznejad, Parker, Barnett and Tavares (2008) Methodology - DEA Input-oriented technical efficiency (TE) measures Overall TE (CRS) Scale efficiency Pure TE (VRS) Malmquist productivity indices Productivity change Efficiency change Technical change Data 537 hospitals in the Guangdong province of China for the period 2004-2006 304 in Pearl River Delta region 51 in the eastern region 94 in the western region 88 in the mountain area 2 outputs: outpatient cases and inpatient cases 5 inputs: the number of doctors; the number of nurses; the number of pharmacists;