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Health Insurance Reform and Efficiency of Township Hospitals in rural China: an Analysis from Survey Data

Abstract : In the rural health-care organization of China, township hospitals ensure the delivery of basic medical services. Particularly damaged by the economic reforms implemented from 1975 to the end of the 1990s, township hospitals efficiency is questioned, mainly with the implementation since 2003 of the reform of health insurance in rural areas. From a database of 24 randomly selected township hospitals observed over the period 2000-2008 in Weifang prefecture (Shandong), the study examines the efficiency of township hospitals through a two-stage approach and the calculation of the Malmquist index. As curative and preventive medical services delivered at township hospital level use different production processes, two data envelopment analysis models are estimated with different orientation chosen to compute scores. Following Simar and Wilson (2007), as the traditional two-stage methodology is not relevant, we used a double bootstrap strategy. Results show that technical efficiency declines over time. Moreover, township hospitals are less efficient in the production of preventive services than in the production of curative ones. Several variables explained efficiency (township hospitals' and environment's characteristics) but our results suggest that in the context of China, the efficiency of township hospitals is also influenced by unobservable factors.
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Preprints, Working Papers, ...
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Contributor : Cerdi Etudes & Documents - Publications <>
Submitted on : Thursday, April 21, 2011 - 2:44:24 PM
Last modification on : Tuesday, January 15, 2019 - 11:26:06 AM
Long-term archiving on: : Friday, July 22, 2011 - 2:32:59 AM


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  • HAL Id : halshs-00587799, version 1


Aurore Pelissier, Martine Audibert, Jacky Mathonnat, Xiao Xian Huang. Health Insurance Reform and Efficiency of Township Hospitals in rural China: an Analysis from Survey Data. 2011. ⟨halshs-00587799v1⟩



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