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Configuration Analysis of Influencing Factors of Technical Efficiency Based on DEA and fsQCA: Evidence from China’s Medical and Health Institutions

Authors Li Z, Zhang W, Kong A, Ding Z, Wei H, Guo Y

Received 15 September 2020

Accepted for publication 3 December 2020

Published 8 January 2021 Volume 2021:14 Pages 49—65

DOI https://doi.org/10.2147/RMHP.S282178

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Marco Carotenuto


Zhiguang Li,1 Wanying Zhang,1 Aijie Kong,1 Zhiyuan Ding,1 Hua Wei,1 Yige Guo2

1School of Economics and Management, Anhui University of Chinese Medicine, Hefei, Anhui, People’s Republic of China; 2King’s Business School, King’s College London, London, UK

Correspondence: Hua Wei
School of Economics and Management, Anhui University of Chinese Medicine, 350 Longzihu Road, Xinzhan District, Hefei 230012, People’s Republic of China
Tel +86-551-68129224
Email weihua@ahtcm.edu.cn

Purpose: This paper aims to measure the technical efficiency of China’s medical and health institutions from 2012 to 2017 and outline the path to achieve high-quality development.
Methods: The DEA-Malmquist was used to evaluate the total factor productivity of medical and health institutions in 31 provinces. A fuzzy set Qualitative Comparative Analysis (fsQCA) was used for configuration analysis of determinants affecting technical efficiency.
Results: The average total factor productivity (TFP) of those institutions was 0.965, namely TFP declined averagely by 3.5% annually. The efficiency change and the technical change were 0.998 and 0.967, respectively. The realization paths of high technical efficiency are composed of high fatality rate and high financial allocation-led, high population density and high GDP-led. Low dependency ratio and low financial allocation-led, low fatality rate and low financial allocation-led are the main reasons for low technical efficiency.
Conclusion: Due to advanced medical technology and economic development, major cities like Beijing, Shanghai, and Guangdong have attracted a large number of high-level health personnel, achieving long-term and stable health business growth. Hubei, Anhui, and Sichuan also have made rapid development of health care through appropriate financial subsidies and policy supports. The technical changes in Qinghai, Yunnan, and Inner Mongolia are higher than the national average, but the operation and management level of the medical and health institutions is relatively weak. Henan, Jiangxi, and Heilongjiang have a prominent performance in the efficiency change, but the technical change is weaker than the national average.

Keywords: China’s medical and health institutions, DEA-malmquist, fsQCA, efficiency, configuration

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