Abstract
BACKGROUND: The efficiency of public hospitals, particularly Traditional Chinese Medicine (TCM) hospitals, has emerged as a critical issue in China's healthcare reform, compounded by challenges such as low diagnostic revenue, regional disparities, and increasing adoption of Western medicine practices. As traditional Chinese medicine plays an indispensable role in managing chronic conditions among older adults, this study addresses critical healthcare challenges within China's aging population context. Therefore, this study aims to systematically analyze the technical efficiency of public TCM hospitals in Hebei Province. METHODS: This research employs an integrated three-stage analytical framework using advanced efficiency measurement techniques to assess the technical efficiency of 21 public TCM hospitals in Hebei Province from 2014 to 2018. The methodology combines static efficiency evaluation with dynamic efficiency analysis, while regression modeling identifies key efficiency determinants. Specifically, data were collected from hospital records and analyzed using Data Envelopment Analysis, Stochastic Frontier Analysis, and Super Slack-Based Measure models. RESULTS: Findings reveal that average technical efficiency of TCM hospitals in Hebei is suboptimal, primarily driven by insufficient pure technical efficiency rather than scale inefficiency. Environmental factors, including geographic location and local TCM practitioner training, significantly influence efficiency levels. Dynamic analysis indicates declining technological progress, counteracting marginal improvements in managerial efficiency. Furthermore, operational and financial factors show varied impacts: bed utilization rates, personnel expenditure ratios, and total asset turnover rates correlate positively, while depreciation costs, management expense ratios, and bed capacity demonstrate negative effects. Consequently, the research emphasizes that internal management optimization should take precedence over scale expansion. CONCLUSIONS: This research contributes to deeper understanding of efficiency dynamics in TCM hospitals through advanced analytical techniques. Most critically, policymakers should prioritize enhancing operational management and targeted resource distribution to achieve sustainable improvements in TCM hospital performance. Additionally, hospital management can benefit from adopting commitment-based practices to improve efficiency performance and optimize healthcare delivery outcomes.