Measurement and analysis of health productivity in China——Based on the perspective of the "Regional Differentiation Study"

Abstract Background Chinese mainland includes 31 provinces, autonomous regions, and municipalities directly under the central government (referred to collectively as provinces for simplicity). There are still a lot of problems in China's medical system, such as regional imbalance, outstanding structural issues, and ineffective management practices. Our study aims to scientifically measure the efficiency of health production using a multi-dimensional approach. We seek to evaluate the differences in efficiency among different regions and provide a scientific reference for improving the overall level of health in China. Methods Our study utilizes statistical methods to assess the health efficiency of 31 provinces in China over the period 2010 to 2020. The analysis incorporates the conventional BCC model, the super-efficient SBM model, and the Malmquist index model within the framework of DEA modeling. And using the Dagum Gini coefficient to further analyze the differences in health productivity of China. Results The traditional BCC model calculated China's comprehensive health production efficiency in 2020 to be 0.732. The pure technical efficiency of 13 provinces was effective, and 6 provinces showed effective comprehensive efficiency, scale efficiency, and DEA. The SBM model assessed the average health productivity value among China's provinces in 2020, revealing Guangdong as the highest (2.276) and Qinghai as the lowest (0.351). The average value of China's Malmquist Index from 2010 to 2020 was 1.002, indicating a slight overall improvement in health production efficiency. Furthermore, the score of technological change and technological efficiency change in five provinces were more than 1. Gini coefficient had obvious downward trend from 2010 to 2020, and there was a lower level in the northeastern (0.055) and eastern (0.0989) regions. Conclusion China's health investment has increased over the years, leading to a notable improvement in the overall health of the population. The nation's health productivity has also been on the rise, although disparities between regions remain evident, particularly between the eastern and western regions. The government should play a significant role in establishing standardized criteria for regular evaluation of health production efficiency levels. It’s suggested to utilize digital health technologies to facilitate the exchange of information among different regions in China, thereby fostering collaborative efforts to improve overall health outcomes. This study aims to boost health productivity in western regions through strategic policy and financial interventions.