Research on the spatial–temporal evolution of healthcare resource allocation efficiency in China

TL;DR

This study analyzes healthcare resource efficiency in China from 2014 to 2023 and suggests strategies to improve healthcare services.

Contribution

The study introduces a customized provincial-level resource rebalancing strategy and emphasizes accelerating medical technology diffusion.

Findings

China's healthcare resource input increased, but output lagged, with a 2023 national average comprehensive efficiency of 0.869.

Regional differences show the eastern region leading in efficiency, while the central region lags and the western region fluctuates.

Technological progress lag is a key factor in the decline of total factor productivity, with an average of 0.984 from 2014 to 2023.

Abstract

To analyze the allocation efficiency of healthcare resources in 31 provinces, municipalities and autonomous regions in China from 2014 to 2023, and propose improvements to enhance the level of healthcare services in China.

The DEA-BCC model was used to measure the static efficiency, and the Malmquist index was used to analyze the dynamic changes of total factor productivity, and the regional efficiency comparison and spatial–temporal evolution analysis were carried out.

The input of healthcare resources in China continued to increase, but the output was lagging behind. In 2023, the national average comprehensive efficiency was 0.869, and more than half of the provinces were DEA-ineffective. Regional differences are obvious, the efficiency of the eastern region is leading, the central region is low, and the western region fluctuates greatly. From 2014 to 2023, the average national total factor productivity was 0.984, and the efficiency showed a slight downward trend. Further decomposition finds that the lag of technological progress is a key factor restricting the improvement of total factor productivity.

A customized resource rebalancing strategy at the provincial level should be implemented to reduce the over-allocation of hospitals and beds. Concurrently, accelerating the diffusion of medical technologies to primary care is essential, and make up for the shortcomings of technological progress through regional cooperation platforms and mandatory equipment update cycles. Furthermore, benchmarking management should be adopted, drawing on the practical experience of high-efficiency provinces in integrated healthcare alliances and digital health integration.

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