Data_Sheet_1_Governmental Investments in Hospital Infrastructure Among Regions and Its Efficiency in China: An Assessment of Building Construction.docx

Hospital infrastructure has been addressed as the prerequisite of healthcare delivery which intensively affects medical quality. Over the past decade, China has proposed a series of investment plans for hospital infrastructure in order to promote healthcare development in underdeveloped regions. Focusing on the construction of hospital buildings as the key component of hospital infrastructure, this study aims to examine whether the investment efficiency is lower where a government prioritizes equity and to explore what kind of geographical predispositions should be embedded in governmental investment plans for hospital infrastructures from the perspectives of both investment equity and efficiency. Relevant data from 330 governmental-invested hospital building construction projects in Sichuan province, China, from 2009 to 2018 were collected. Concentration index was used to evaluate the equity in the distribution of the investments. Tobit model was employed to explore the relationship between regional economic development and investment efficiency measured by an integrated approach of principal component analysis and data envelopment analysis. The results demonstrated a slight concentration of governmental investments in economically developed regions, while a negative association with regional economic development was identified with investment efficiency. Our study illustrated the investment efficiency was higher where a government prioritized equity and provided empirical evidences on switching governmental investment predisposition in the aspect of healthcare infrastructure construction toward less developed regions in China from the perspectives of both investment allocation equity and efficiency, which would further assist in the formulation of region-specific policies and strategies for underdeveloped regions.

医院基础设施被视为医疗服务开展的前提条件，对医疗质量有着深刻影响。近十年来，中国推出一系列医院基础设施投资计划，以推动欠发达地区的医疗卫生事业发展。本研究以医院基础设施的核心组成部分——医院楼宇建设为研究对象，旨在验证政府优先考量公平性时，投资效率是否更低；同时从投资公平性与效率双重视角，探讨政府医院基础设施投资计划应嵌入何种地理禀赋条件。本研究收集了2009至2018年中国四川省330个政府投资的医院楼宇建设项目相关数据。采用集中度指数（Concentration Index）评估投资分配的公平性，采用主成分分析（Principal Component Analysis）与数据包络分析（Data Envelopment Analysis）相结合的集成方法测度投资效率，并运用Tobit模型（Tobit Model）探讨区域经济发展与投资效率之间的关联。研究结果显示，政府投资在经济发达地区存在轻微的集中趋势；同时发现投资效率与区域经济发展呈负相关关系。本研究证实，当政府优先考量公平性时，投资效率更高；同时从投资分配公平性与效率双重视角，为中国调整医疗卫生基础设施建设的政府投资取向、向欠发达地区倾斜提供了实证依据，进而有助于为欠发达地区制定因地制宜的医疗卫生政策与发展策略。