Study On Operation Efficiency Evaluation Of Maternal And Child Health Care Institutions Based On Data Envelopment Analysis Method

Objective This study was to understand the status of resources and operation of maternal and child health care institutions in different regions and level in Guangdong province,to compare and analyze its operational management efficiency,and to provide reference for optimizing the configuration and improving management efficiency and establishing policy of child health care institutions.Methods Using the annual monitoring data of the resources and operation of 114 child care institutions in Guangdong province from 2007-2016,the combination of different input and output indexes were adopted for document metrology screening analysis,using DEA-Malmquist analysis of input and output efficiency,calculate different regions and levels of maternal and child health institutions and overall total factor productivity,compare and analysis of different maternal and child health institutions efficiency results.Results 1.By screening indicators in the output orientation,3 input indicators were included: total expenditure,health technicians fixed assets and 5 output indexes: discharge number,surgery number,total revenue,outpatient number,total number of days at the base.2.After removing the missing value,114(82.01%,114/139)maternal and child health institutions were applied to the DEA model.69 institutions increased their total factor productivity(mean 1.028),accounting for 60.53%,and 45 institutions(39.47%)of the total factor productivity declined(mean 0.973),half of the institutions(39/69)have increased and one third institutions(19/38)decreased TFP as a result of the combined effects of TC and TE.From 2007 to 2016,none of the institutions in Guangdong could maintain continuous efficiency rising for 10 years.The cross-Malmquist index showed that the average total factor productivity of 2007-2016 was 1.006,and overall productivity increased by 0.6%.The efficiency change index was 0.998,the efficiency decreased by 0.2%,the technical change index was 1.008,increasing 0.8%,the scale efficiency was 1.003,increased by 0.3%,the pure technical efficiency was 0.995,decreased by 0.5%.The overall efficiency index showed alternately rise and the descend in a floating pattern,the technology change index was consistent with the trend of total factor productivity,the results show that the total factor productivity is caused by the technological change.3.Comparison of the efficiency of maternal and child health institutions in 21 cities shows that the highest total factor productivityis Shenzhen,which TFP is 1.045,and the lowest is Qingyuan(mean 0.962).The average total factor productivity of 14 cities increased(mean 1.019),while the remaining 7 cities were in decline(mean 0.986),respectively Qingyuan,Zhanjiang,Shanwei,Heyuan,Shantou,Jiangmen,Yunfu.Among the risen cities that 6 of 14 cities have combined to affected changes in TFP by TC and TE,in addition,the increase in TFP the other 7 cities has been attributed to advances in TC.The decline in 3 of 7 cities is the result of TC and TE.4.Comparing the regional analysis results,the total factor productivity of the maternal and child health care institutions in the pearl river delta was the highest,which was 1.021,the reason for improvement is the role of technological change.Follow by the eastern part with 1.010,and the lowest is 0.991 in the west wing area and the mountain area,the increase and decrease of efficiency are caused by the technology change and the technical efficiency.In the pearl river delta region,there were 39(76.47%,mean 1.032)of the TFP improved,with 12(23.53%,mean 0.984)declined,and 16TFP(48.48%,mean 1.021)in the northern Guangdong province improved,and 17 decreased(51.52%,mean 0.962).There were 7TFP improved(36.84%,mean 1.024)in the west wing area and 12(63.16%,mean 0.972)decreased.TFP in the eastern region with 7(63.64%,mean 1.026)increased and 4(36.36%,mean 0.982)decreased.5.Comparing of the efficiency of different levelsshows that the efficiency of the third grade was the highest(mean1.026),and the unrated grade institution was the lowest(0.993).the increase and decrease of total factor productivity are caused by the technology change and the technical efficiency.Except the third grade institutions,the average efficiency value of the rest institutions lower than the average total factor productivity.Conclusion From 2007 to 2016,the basic operation of maternal and child health care institutions in Guangdong Provice kept increasing year by year,and TFP showed a volatility increase.The TFP index is mainly affected by the change of TC and TE,and the efficiency of institution in different regions and grades is more significant,Ineconomically developed areas and higher levels of institutions,its TFP rate is higher,and the constrction and management institutions should be conducted in conjunction with the efficiency analysis.For the west wing area,the mountain areaand ungraded categories of maternal child health care institutions,they should pay more attention to the technical efficiency change caused by pure technical efficiency,and strengthening the management of its support and public health investment,while control the scale to avoid excessive investment in expansion.