Measurement of the operational efficiency of tertiary public hospitals in Western China: evidence from Guangxi from 2019 to 2022

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Abstract
Objective: The continuous increase in health care costs and the growing demand for health services among residents make it an urgent priority to improve the operational efficiency of the health system in Chinese society. In this study, data on the operational efficiency of tertiary public hospitals in Guangxi were analyzed to identify issues in hospital management within the context of performance assessment, which thereby enhanced the social service capacity of hospitals.Methods: A comprehensive evaluation index system was constructed based on the “national monitoring indicators” of operational efficiency. The indicators were analyzed using data envelopment analysis with Banker, Charnes and Cooper (DEA-BCC) and Malmquist index models. The Tobit regression model was used to analyze the major factors affecting the efficiency of public hospitals.Results: Between 2019 and 2022, the pure technical efficiency (PTE) of 61 tertiary public hospitals in Guangxi remained at a relatively high level. The results of the Malmquist index showed a downward trend. The technical progress (TC) indicator became the main factor affecting the decline in the operational efficiency of hospitals. Tobit regression analysis revealed that plenty of factors exerted a significant impact on the operating efficiency of hospitals. These factors included the number of beds, the ratio of outpatient and inpatient patients relative to total patient numbers, the proportion of discharged patients undergoing surgery among total patients, business expenditures and total annual revenue.Conclusion: The scale of tertiary public hospitals in Guangxi is prominently unreasonable. It is necessary to raise the efficiency of resource utilization. The operation and management situation is not optimistic. Hospitals should accelerate the transformation of their development model, rationally allocate medical resources and shift from scale expansion to the improvement of quality and efficiency. Meanwhile, they should actively participate in establishing the hierarchical medical treatment system, controlling operating costs and reasonably increasing the proportion of personnel expenses to improve operational and management efficiency.

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