Study of the medical service efficiency of county-level public general hospitals based on medical quality constraints: A cross-sectional study

Objectives: Since the new medical reform in 2009, county-level hospitals in China have achieved rapid development, but health resource waste and shortage issues still exist.
Design: We applied the Meta-frontier and SBM-undesirable（Slacks-based Measurement-undesirable) DEA(Data Envelopment Analysis) model to measure the medical service efficiency with or without medical quality constraints of the county-level public general hospitals (CPGHs). The assessment includes four inputs, three desirable outputs, and one undesirable output. We conducted the assessment via Max-DEA V.8.19 software. Moreover, we analyze the factors affecting CPGHs’ medical service efficiency based on the FRM model. 
Setting: A total of 77 sample CPGHs were selected from Shanxi province in China from 2013 to 2018.
Results: The results of this study showed that the efficiency level of county-level public hospitals in Shanxi Province is relatively low overall (the mean value of efficiency is 0.61 without quality constra..., The data are mainly from the 2013–2018 Shanxi (a province with a population of 37 million in China) Statistical Yearbook and China Health Statistics Yearbook. Overall, 77 CPGHs in Shanxi Province were selected. The data excluded other types of hospitals, such as traditional Chinese medical hospitals, maternal and child health care hospitals and other medical institutions, so they met the homogeneity requirement of the DEA(Data Envelopment Analysis) method.,