Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals from 2009 to 2016: A Bootstrap-Data Envelopment Analysis

Abstract Objective: It was to estimate the productivity and efficiency of Traditional Chinese Medicine (TCM) hospitals to provide empirical evidence for hospital managers and policy-makers to improve the management and quality of TCM service.Methods: The data of the individual tertiary public TCM hospitals were collected from official Yearbooks of Traditional Chinese Medicine of China (2010-2017). Bootstrap-Malmquist-DEA was employed to measure the productivity and efficiency (2009-2016). SPSS23.0 was used to conduct the descriptive analysis of the input and output indicators. R3.2.1 was applied to calculate the productivity and efficiency with FEAR package. The statistical significance was set at P < 0.05.Results: The annual average growth rates of each indicator were 6.61% (health professionals), 8.15% (actual open beds), 7.08% (outpatients and inpatients) and 12.50% (discharged patients) respectively from 2009 to 2016. Except the total factor productivity change (TFPC) between 2014 and 2015, more than half of the TCM hospitals had TFPC scores over 1.000. The overall annual geo-mean TFPC score was 1.0379.Conclusions: The overall annual rate of the TFPC of the tertiary public TCM hospitals was slightly increased. The technological progress was the main driver to improve the total factor productivity. The decreased technical efficiency was more affected by the decreased scale efficiency. The TCM hospitals need to pay attention to the development and innovation of the TCM technology, thereby improving the competitiveness. The TCM hospitals managers should pursuit the high quality, high efficiency and low cost of the TCM services.