Efficiency Comparison of Public Hospitals under Different Administrative Affiliations in China: A Pilot City Case

This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.