Operational efficiency in public infectious disease hospitals across 31 provinces in China: a three-phase data envelopment analysis.

OBJECTIVE

Infectious disease hospitals (IDHs) are core components of the national public health system, and high-quality development (HQD) of IDHs is a priority in this system. This study aimed to systematically analyse the operational status of public IDHs in China and provide empirical references for HQD.

DESIGN AND

SETTING

A comprehensive survey approach was adopted to collect operation-related data from 133 public IDHs across 31 provinces in China in 2023. A three-phase data envelopment analysis (DEA) was applied to measure the operational efficiency (OE) of IDHs in each province. Phase 1 calculated raw efficiency and input slacks. Phase 2 eliminated environmental interference to adjust inputs. Phase 3 recalculated adjusted OE.

RESULTS

The third-phase DEA results indicated that the average values of technical efficiency (TE), pure technical efficiency (PTE) and scale efficiency (SE) of public IDHs in China were 0.610, 0.681 and 0.914, respectively. The IDHs in Beijing, Hainan, Tianjin, Sichuan and Tibet maintained an effective OE after adjustment for environmental factors. The adjusted mean TE and PTE exhibited a geographic variation of 'East>Central > West > Northeast', while the average SE showed a reverse trend of 'Northeast>Central > West > East'. The stochastic frontier analysis regression results showed that per capita GDP (p<0.001) was significantly positively correlated with OE, while urbanisation level (p<0.001) and the number of participants in basic medical insurance (p=0.025) both exhibited significant negative associations with OE.

CONCLUSIONS

The OE of public IDHs in China was generally low. TE was mainly constrained by PTE and exhibited significant regional heterogeneity. Each region should adjust measures to local conditions to reasonably determine the construction scale of IDHs, improve infrastructure and medical equipment and focus on enhancing hospitals' capabilities in refined management and medical technology standards, thereby promoting the HQD of IDHs in China.