{"title":"基于DEA和集中度指标的卫生服务资源配置效率与公平性：来自甘肃省中医院的证据","authors":"Yahui Ba, Zhonghua Luo","doi":"10.3389/fpubh.2025.1674348","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Traditional Chinese medicine (TCM) hospitals are vital to China's healthcare system, yet concerns persist about the efficiency and equity of resource allocation. Variations in economic development across cities within a province lead to disparities in allocation efficiency, with many TCM hospitals facing challenges like low technical efficiency and uneven resource distribution. These issues hinder quality healthcare delivery and compromise fairness.</p><p><strong>Methods: </strong>Using health statistics data (2018-2024) from China's Gansu Provincial Bureau of Statistics, this study employed a three-stage Data Envelopment Analysis (DEA) model, the Malmquist index, and Health Resources Agglomeration Degree (HRAD) to evaluate the efficiency and equity of TCM hospital resource allocation across 14 cities in the province.</p><p><strong>Results: </strong>In 2024, the comprehensive technical efficiency of healthcare services at Gansu Provincial TCM Hospital was 0.961, with 10 regions being DEA-effective, 1 showing weak effectiveness, and 3 deemed ineffective. After adjusting environmental variables and random disturbances in the third-stage analysis, the recalculated efficiency metric stands at 0.962, showing minimal variation. This indicates that environmental factors exert a negligible influence on efficiency. From 2018 to 2024, total factor productivity declined annually, indicating significant room for efficiency improvement. Resource allocation equity varied widely across regions, with notable disparities in both geographical concentration and population-based distribution observed during the study period.</p><p><strong>Conclusions: </strong>The efficiency and equity of resource allocation of TCM hospitals require substantial improvement. Insufficient resources limit hospital performance, and while technical efficiency surpasses allocation efficiency, overall technical standards remain inadequate. Geographic inequities in resource distribution are particularly pronounced. To address these challenges, establishing a provincial resource allocation mechanism, enhancing infrastructure in low-efficiency areas, and coordinating resource distribution across economically diverse cities are essential to optimize both efficiency and fairness.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1674348"},"PeriodicalIF":3.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521092/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficiency and equity of resource allocation in healthcare services using DEA and concentration indices: evidence from the traditional medicine hospital in Gansu Province, China.\",\"authors\":\"Yahui Ba, Zhonghua Luo\",\"doi\":\"10.3389/fpubh.2025.1674348\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Traditional Chinese medicine (TCM) hospitals are vital to China's healthcare system, yet concerns persist about the efficiency and equity of resource allocation. Variations in economic development across cities within a province lead to disparities in allocation efficiency, with many TCM hospitals facing challenges like low technical efficiency and uneven resource distribution. These issues hinder quality healthcare delivery and compromise fairness.</p><p><strong>Methods: </strong>Using health statistics data (2018-2024) from China's Gansu Provincial Bureau of Statistics, this study employed a three-stage Data Envelopment Analysis (DEA) model, the Malmquist index, and Health Resources Agglomeration Degree (HRAD) to evaluate the efficiency and equity of TCM hospital resource allocation across 14 cities in the province.</p><p><strong>Results: </strong>In 2024, the comprehensive technical efficiency of healthcare services at Gansu Provincial TCM Hospital was 0.961, with 10 regions being DEA-effective, 1 showing weak effectiveness, and 3 deemed ineffective. After adjusting environmental variables and random disturbances in the third-stage analysis, the recalculated efficiency metric stands at 0.962, showing minimal variation. This indicates that environmental factors exert a negligible influence on efficiency. From 2018 to 2024, total factor productivity declined annually, indicating significant room for efficiency improvement. Resource allocation equity varied widely across regions, with notable disparities in both geographical concentration and population-based distribution observed during the study period.</p><p><strong>Conclusions: </strong>The efficiency and equity of resource allocation of TCM hospitals require substantial improvement. Insufficient resources limit hospital performance, and while technical efficiency surpasses allocation efficiency, overall technical standards remain inadequate. Geographic inequities in resource distribution are particularly pronounced. To address these challenges, establishing a provincial resource allocation mechanism, enhancing infrastructure in low-efficiency areas, and coordinating resource distribution across economically diverse cities are essential to optimize both efficiency and fairness.</p>\",\"PeriodicalId\":12548,\"journal\":{\"name\":\"Frontiers in Public Health\",\"volume\":\"13 \",\"pages\":\"1674348\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521092/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Public Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fpubh.2025.1674348\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fpubh.2025.1674348","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Efficiency and equity of resource allocation in healthcare services using DEA and concentration indices: evidence from the traditional medicine hospital in Gansu Province, China.
Background: Traditional Chinese medicine (TCM) hospitals are vital to China's healthcare system, yet concerns persist about the efficiency and equity of resource allocation. Variations in economic development across cities within a province lead to disparities in allocation efficiency, with many TCM hospitals facing challenges like low technical efficiency and uneven resource distribution. These issues hinder quality healthcare delivery and compromise fairness.
Methods: Using health statistics data (2018-2024) from China's Gansu Provincial Bureau of Statistics, this study employed a three-stage Data Envelopment Analysis (DEA) model, the Malmquist index, and Health Resources Agglomeration Degree (HRAD) to evaluate the efficiency and equity of TCM hospital resource allocation across 14 cities in the province.
Results: In 2024, the comprehensive technical efficiency of healthcare services at Gansu Provincial TCM Hospital was 0.961, with 10 regions being DEA-effective, 1 showing weak effectiveness, and 3 deemed ineffective. After adjusting environmental variables and random disturbances in the third-stage analysis, the recalculated efficiency metric stands at 0.962, showing minimal variation. This indicates that environmental factors exert a negligible influence on efficiency. From 2018 to 2024, total factor productivity declined annually, indicating significant room for efficiency improvement. Resource allocation equity varied widely across regions, with notable disparities in both geographical concentration and population-based distribution observed during the study period.
Conclusions: The efficiency and equity of resource allocation of TCM hospitals require substantial improvement. Insufficient resources limit hospital performance, and while technical efficiency surpasses allocation efficiency, overall technical standards remain inadequate. Geographic inequities in resource distribution are particularly pronounced. To address these challenges, establishing a provincial resource allocation mechanism, enhancing infrastructure in low-efficiency areas, and coordinating resource distribution across economically diverse cities are essential to optimize both efficiency and fairness.
期刊介绍：
Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice.
Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.
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