Zhongguo quanke yixue (Apr 2023)

Changes in the Efficiency of Member Township Hospitals in County-level Medical Communities Constructed in Typical National Pilot Areas

  • MENG Yeqing, LI Sisi, QIN Jiangmei, LIN Chunmei, ZHANG Yanchun, ZHANG Lifang

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0525
Journal volume & issue
Vol. 26, no. 10
pp. 1212 – 1217

Abstract

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Background The county-level medical community has helped improve the capacity of primary care institutions and the quality of primary care services, and promoted the operational efficiency of primary care institutions through various "strengthening primary healthcare" measures. Objective To evaluate the efficiency of service delivery and the total factor productivity (TFP) of member township hospitals in county-level medical communities constructed in typical national pilot areas in China. Methods We collected the annual monitoring data and annual health statistics reports during 2018 to 2019 of county-level medical communities (involving 143 member township hospitals) in eight counties (cities) of four regions in central and western China (Anhui Province, Jiangxi Province, Guangxi Zhuang Autonomous Region and Xinjiang Uygur Autonomous Region). We used data envelopment analysis (DEA) and Malmquist inde (MI) to analyze the change in TFP of the township health hospitals before and after the pilot construction of county medical communities. Results Taking the county as the decision-making unit, compared with 2018, the technical efficiency change, technological progress change, pure technical efficiency change, scale efficiency change and TFP change of township hospitals in the typical areas in 2019 were 0.977, 1.037, 0.995, 0.982 and 1.013, respectively, and the TFP of township hospitals increased by 1.3% on average. Taking township health centers as the decision-making unit, compared with 2018, the TFP of township hospitals increased by 4.5% in 2019. Specifically, the TFP of township hospitals increased by 47.83% in Anhui's A1 county, 66.67% in Anhui's A2 county, 54.84% in Jiangxi's B1 county, 59.26% in Jiangxi's B2 county, 70.00% in Guangxi's C1 county, 90.91% in Guangxi's C2 county, 78.57% in Xinjiang's D1 county, and 55.56% in Xinjiang's D2 county. Conclusion The "strengthening primary health care" measures implemented during the reform of county-level medical communities have played a role in elevating the efficiency of township hospitals. The continuous improvement in the efficiency of township hospitals relies on both the leading hospital providing targeted assistance and mobilizing the productivities and enthusiasm of the township hospitals.

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