ABSTRACT
First, this study used only nine indicators (two input indicators and seven output indicators) to examine the efficiency of the health care system in China. As the inputs and outputs of the health care system are very complicated, any assessment and evaluation can only provide insight into one aspect of the system. Although this study divided the input and output of the health care system into medical and public health services and endeavoured to select as many as nine key performance indicators, it could only give a partial reflection of the efficiency of China’s health care system and implied nothing about other factors. Since 2009, the implementation of a basic public health service policy has included nine categories, but only maternal and child care were examined here because of data availability. Planned immunization and chronic disease management, which achieve great results, were not studied. Second, with regard to the effect of health care reform policy on health system efficiency, the TOBIT model applied in this study could only suggest that the decline in efficiency was correlated to the implementation of the New Health Care System Reform policy but could not confirm a causal relationship between the two. Studying the causality between health care reform and health system efficiency requires estimation using randomized controlled trials or quasi-experiments, which is beyond the scope of this article. Third, this study examined the impact of health care reform on the efficiency of China’s health care system at the macro level but did not look at the influencing mechanisms in detail. To solve this issue, further research should be conducted at the micro level to investigate how health care reform has affected health care system efficiency.
