Paper Title
Measuring The Efficiency and Productivity Changes in Public Hospitals of China: A Bootstrapping-MPI Approach

Objective: Improving the efficiency and productivity is one of the challenges facing the health sectors worldwide. The first and foremost task for the policy-makers is how to measure them accurately. This study aimed to measure the changes in Total Factor Productivity of public hospitals in China precisely. Methods: The Bootstrapping-Data envelopment analysis (DEA) technique was employed to estimate the technical efficiency(TE), pure technical efficiency(PTE) and scale efficiency(SE) of 86 tertiary general public hospitals in three provincial regions of China by 4 input and 4 output indicators with panel data of 2011-2013. And then the Bootstrapping-Malmquist Productivity Indices (MPI) approach was applied to measure the Total Factor Productivity Change(TFPC). Results: In the period of 2011-2013, the Total Factor Productivity of the sample hospitals had declined 2.09% yearly and the main deterioration came from technological recession (-4.46%). The technical efficiency had simultaneously increased 2.60% with the contributions coming from both the pure technical efficiency(1.72%) and the scale efficiency (0.88%).Conclusions: The overall efficiency and productivity of the sample hospitals had slightly deterioration yearly for the technological recession. Keywords: Malmquist Productivity Indices (MPI), Data Envelopment Analysis (DEA), Bootstrapping, Total Factor Productivity(TFP), Technological Change, Technical Efficiency, public hospital, China