Analysis Of The Efficiency And The Influencing Factors Of Provincial Maternal And Children’s Health Institutions

ObjectiveTo evaluate the efficiency of Provincial MCH institutions and explore the influencing factors of technical efficiency (TE), providing specific policies and suggestions not only for increasing the efficiency of Provincial MCH institutions, but also for the development and focus of MCH institutions.MethodsCollecting data of MCH institutions in the province level form MCH institutions monitoring system and statistical yearbook of the province level, describing statistics by the maximum, minimum, median and mean statistical indicators, and the trend of related indexes of resources in MCH institutions from the year of2008to2012by statistical indicators or charts. The suitable input and output indexes were selected by four methods such as correlation coefficient method, cluster analysis method, factor analysis method and literature method. Using Data Envelopment Analysis method to calculate technical efficiency, pure technical efficiency and scale efficiency of Provincial MCH institutions from three directors such as entirety, medical service and health care service, meanwhile ranking for MCH institutions by super efficiency. Then the influencing factors of TE were explored by Tobit regression.ResultsThe median financial subsidies, business expense, business income, the number of medical equipment priced ten thousands above, the number of researches and scientific research funds increased rapidly, but the median number of health personnel, beds and number of discharged patients changed more slowly. The selected input indexes were the number of health technicians, the area of business house, annual business expenditure and financial subsidies; The selected output indexes were annual business income, annual numbers of diagnosis and treatment, the bed turnover rate, the providing rate of maternity and child care services, days of guiding population health care to grass roots and annual numbers of research projects. The entire service technique effectiveness rate (TER) was75%, and the average TE was0.962; the medical service TER was55%, and the average TE was0.880; the health care service TER was45%, and the average TE was0.711. The ranking of overall service TE and medical service TE were west, east and central section, but health service TE efficiency is the highest in central. There were six MCH institutions that three kinds of TE were good, eleven ones that health service TE was worst, three ones that medical service TE was worst. Results of Tobit regression analysis showed that the proportion of medical graduates in total workers, economic indicators of GDP and service population were positive significant determinants of TE about entire, medical and health care service; number of jurisdictions obstetric institutions, the ratio of fiscal investment, the ratio of drug income, the rate of doctors and nurses and asset-liability ratio were negative significant determinants.ConclusionsIn a word, China’s provincial MCH institutions overall develop very well. But there is an unbalance between the medical service efficiency and health care service efficiency and a status quo of more attention to medicine but fewer to health care in some institutions. The influence factors of TE are concentrated on three sides such as allocation way and income composition, predisposition for medical professional workers, economy and service population. Further investment in MCH institution development, especially in staff capacity building should be strengthened in order to further increase the TE.