Measuring Technical Efficiency and Productivity of Secondary Maternal and Child Health Hospitals in Hubei, China: Some Evidences from Hubei Province of China 2019 to 2021.

Environmental factors like COVID-19 can have significant impact on technical efficiency (TE) and total factor productivity (TFP) of health services provided. In this study, focusing on Maternal and Child Health (MCH) hospitals in Hubei Province of China in 2019 to 2021, we aimed to measure their TE and TFP, identify some influential environmental factors, and propose some policy recommendations. Altogether 62 secondary MCH hospitals were selected as the study sample. Four input indicators, 3 output indicators, and 4 environmental indicators were selected to analyze the panel data from 2019 to 2021. Three-stage Data Envelopment Analysis (DEA) and Malmquist Productivity Index (MPI) model were employed to estimate the TE and TFP of these hospitals. During 2019 to 2021, the inputs of the sample hospitals had increased, while the outputs had decreased. The inputs redundancy was negatively associated with birth rate, number of residents, and GDP per capita (P < .05). It was positively associated with number of COVID-19 infections (P < .05). The adjusted TE scores in 2019 to 2021 were 0.822, 0.784, and 0.803, respectively. The TFP declined in 2020 and 2021 compared to 2019, with scores being 0.845 and 0.762. The technical efficiency change (TEC) scores from 2019 to 2021 were 0.926 and 1.063. The technological change (TC) scores from 2019 to 2021 were 0.912 and 0.716. During 2019 to 2021, the operation of sample hospitals had been significantly influenced by environmental factors like COVID-19 pandemic, low birth rate, number of residents, and GDP per capita. The inputs had increased but outputs had decreased, leading to an increase in inputs redundancy and a decline in TE. The TFP showed a downward trend, with TC and SEC being the priority directions for improvement. Some recommendations are made for both hospitals and government to continuously improve the TE and TFP.