A two-stage Data Envelopment Analysis Approach Incorporating Global Bounded Adjustment Measure to evaluate the efficiency of medical waste recycling systems with undesirable inputs and outputs

A two-stage Data Envelopment Analysis Approach Incorporating Global Bounded Adjustment Measure to evaluate the efficiency of medical waste recycling systems with undesirable inputs and outputs | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A two-stage Data Envelopment Analysis Approach Incorporating Global Bounded Adjustment Measure to evaluate the efficiency of medical waste recycling systems with undesirable inputs and outputs Wen-Jing Song, Jian-Wei Ren, Chun-Hua Chen, Chen-Xi Feng, Lin-Qiang Li, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4122166/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract With the ever-increasing focus on sustainable development, recycling waste and renewable use of waste products has earned immense consideration from academics and policy-makers. The serious pollution, complex types, and strong infectivity of medical waste (MW) have brought serious challenges to management. Although several researchers have addressed the issue of the MW by optimizing MW management networks and systems, there is still a significant gap in systematically evaluating the efficiency of MW recycling systems. Therefore, this paper proposes a two-stage data envelopment analysis (DEA) approach that combines the virtual frontier and the global bounded adjustment measure (BAM-VF-G), considering both undesirable inputs and outputs. In the first stage, the BAM-G model is used to evaluate the efficiency of MW recycling systems, and the BAM-VF-G model is used to further rank super-efficient MW recycling systems. In the second stage, two types of efficiency decomposition models are proposed. The first type of models decomposes unified efficiency into production efficiency (PE) and environment efficiency (EE). Depending upon the systems structure, the second type of models decomposes unified efficiency into the efficiency of the MW collection and transport subsystem (MWCS) and the efficiency of the MW treatment subsystem (MWTS). The novel approach is used to measure the efficiency of the MW recycling systems in China's new first-tier cities (CNFCs), and we find that: (1) Foshan ranks the highest in efficiency, followed by Qingdao and Dongguan, with efficiency values of 0.3593, 0.1765, and 0.1530, respectively. (2) EE has always been lower than PE and is a critical factor influencing the overall efficiency of MW recycling systems in CNFCs. (3) The MWCS lacks resilience, with an efficiency 0.042 lower than that of the MWTC. Following the outbreak of COVID-19, the efficiency of the MWCS has been decreasing year by year, reaching only 0.762 in 2021, which is a decline of 0.111 compared to 2017. Medical waste Global bounded adjusted measure Virtual frontier Efficiency decomposition Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4122166","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":281155044,"identity":"848a27e0-b9a0-4cc7-b0c6-257a7ac19508","order_by":0,"name":"Wen-Jing Song","email":"","orcid":"","institution":"Inner Mongolia University","correspondingAuthor":false,"prefix":"","firstName":"Wen-Jing","middleName":"","lastName":"Song","suffix":""},{"id":281155045,"identity":"763e3b1f-561a-4db0-956c-03433865b09f","order_by":1,"name":"Jian-Wei Ren","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAoklEQVRIiWNgGAWjYFCCA4wPEsCMBOK1MBuQqoWBTYKBJC3mjWfMKh7mHGbgZ88xYPi5gwgtMgfOmN1I3HaYQbLnjQFj7xkitEgwnN0G1mJwI8eAmbGNSC0FIC32JGlhANsiQbyW858lErel80iceVZwsJcoLRLHEj/+3GYtx9+evPHBT2K0MEgcAFM8IOIAMRoYGPgbiFM3CkbBKBgFIxgAAPRQNnlVSrVGAAAAAElFTkSuQmCC","orcid":"","institution":"Inner Mongolia University","correspondingAuthor":true,"prefix":"","firstName":"Jian-Wei","middleName":"","lastName":"Ren","suffix":""},{"id":281155046,"identity":"7c425a53-e9fb-4f35-851b-af3f46d847a8","order_by":2,"name":"Chun-Hua Chen","email":"","orcid":"","institution":"Inner Mongolia Agricultural Uni-versity","correspondingAuthor":false,"prefix":"","firstName":"Chun-Hua","middleName":"","lastName":"Chen","suffix":""},{"id":281155047,"identity":"215ec896-112f-4c47-935d-a64e7da268d3","order_by":3,"name":"Chen-Xi Feng","email":"","orcid":"","institution":"Inner Mongolia University","correspondingAuthor":false,"prefix":"","firstName":"Chen-Xi","middleName":"","lastName":"Feng","suffix":""},{"id":281155048,"identity":"7e1ec073-892c-4047-b4e3-af2f7fbfcb46","order_by":4,"name":"Lin-Qiang Li","email":"","orcid":"","institution":"Inner Mongolia University","correspondingAuthor":false,"prefix":"","firstName":"Lin-Qiang","middleName":"","lastName":"Li","suffix":""},{"id":281155049,"identity":"10f05e27-e26c-4936-82b1-30e6416895e4","order_by":5,"name":"Chong-Yu Ma","email":"","orcid":"","institution":"Inner Mongolia University","correspondingAuthor":false,"prefix":"","firstName":"Chong-Yu","middleName":"","lastName":"Ma","suffix":""}],"badges":[],"createdAt":"2024-03-18 10:12:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4122166/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4122166/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53813332,"identity":"60d6dc1d-2aab-46ab-ab9c-ea433a2bf0d6","added_by":"auto","created_at":"2024-03-31 15:37:57","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":882870,"visible":true,"origin":"","legend":"","description":"","filename":"Theefficiencyofmedicalwasterecyclingsystems10.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4122166/v1_covered_9dd0accf-bbd0-4f5f-a4e8-049bf44720af.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A two-stage Data Envelopment Analysis Approach Incorporating Global Bounded Adjustment Measure to evaluate the efficiency of medical waste recycling systems with undesirable inputs and outputs","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Medical waste, Global bounded adjusted measure, Virtual frontier, Efficiency decomposition","lastPublishedDoi":"10.21203/rs.3.rs-4122166/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4122166/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eWith the ever-increasing focus on sustainable development, recycling waste and renewable use of waste products has earned immense consideration from academics and policy-makers. The serious pollution, complex types, and strong infectivity of medical waste (MW) have brought serious challenges to management. Although several researchers have addressed the issue of the MW by optimizing MW management networks and systems, there is still a significant gap in systematically evaluating the efficiency of MW recycling systems. Therefore, this paper proposes a two-stage data envelopment analysis (DEA) approach that combines the virtual frontier and the global bounded adjustment measure (BAM-VF-G), considering both undesirable inputs and outputs. In the first stage, the BAM-G model is used to evaluate the efficiency of MW recycling systems, and the BAM-VF-G model is used to further rank super-efficient MW recycling systems. In the second stage, two types of efficiency decomposition models are proposed. The first type of models decomposes unified efficiency into production efficiency (PE) and environment efficiency (EE). Depending upon the systems structure, the second type of models decomposes unified efficiency into the efficiency of the MW collection and transport subsystem (MWCS) and the efficiency of the MW treatment subsystem (MWTS). The novel approach is used to measure the efficiency of the MW recycling systems in China's new first-tier cities (CNFCs), and we find that: (1) Foshan ranks the highest in efficiency, followed by Qingdao and Dongguan, with efficiency values of 0.3593, 0.1765, and 0.1530, respectively. (2) EE has always been lower than PE and is a critical factor influencing the overall efficiency of MW recycling systems in CNFCs. (3) The MWCS lacks resilience, with an efficiency 0.042 lower than that of the MWTC. 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