Estimating the Distribution and Convergence of County-level Healthcare Resources Allocative Efficiency in China Based on DEA and Spatial Panel Model

• Published in: Inquiry (Chicago) Vol. 60; p. 469580231178122
• Main Authors: Sun, Jialiang, Sun, Zesheng, Yang, Chenyi, Shen, Yuqing
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2023; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Allocation; China; Counties; Data; Data envelopment analysis; Distribution; Efficiency; Efficiency, Organizational; Health care policy; Health Care Reform; Health services; Heterogeneity; Humans; Original Research; Provinces; Reforms; Resource Allocation; Resources; Spatial analysis; Variance analysis; China; Henan China; data envelopment analysis (DEA); spatial analysis; allocation of healthcare resources; convergence; China; spatial panel model; allocative efficiency
• ISSN: 0046-9580; 1945-7243
• DOI: 10.1177/00469580231178122

Although China’s 2009 New Healthcare Reform aimed to correct the imbalance in the spatial allocation of healthcare resources with a focus on the county level, its impact on county-level allocative efficiency evolution and convergence remains unclear. This paper for the first time performs a spatial analysis to explore the distribution, evolution, and convergence of the allocative efficiency of healthcare resources with county-level data. This paper uses the sample data of 158 countries in Henan Province, China, to evaluate the evolution and convergence of the allocative efficiency of healthcare resources. Based on the estimated Data Envelopment Analysis (DEA) allocative efficiency, analysis of variance (ANOVA), and spatial descriptive analysis, we explore the county heterogeneity and efficiency evolution; a spatial panel model is then utilized to test the county-level convergence of the allocative efficiency of healthcare resources. Although the number of efficient counties has not increased, the number of inefficient individuals keeps decreasing, and the allocative efficiency of municipal districts is lower than that of nonmunicipal counties. There exists a positive spatial correlation of allocative efficiency in Henan Province, and significant and robust convergence results can be found at the county level after China’s 2009 reform. This study reveals a diversified picture of China’s county-level spatial evolution of allocative efficiency in healthcare resources, showing a more balanced spatial distribution of allocative efficiency since the triggering of China’s 2009 reform. However, long-term investment incentives and a targeted allocation of healthcare resources are still needed to promote further efficiency convergence and increase the number of counties with efficiency.