Measurement and characteristics of the temporal-spatial evolution of China's healthcare services efficiency.

Background: Healthcare services efficiency (HSE) is directly related to the healthcare demands of the general public and also plays an essential role in the country's coordinated economic and social development.

Methods: In this study, the stochastic frontier approach (SFA)-Malmquist model was applied to measure the HSE of 31 Chinese provinces based on panel data from 2010-2020. Then, kernel density estimation, Markov chain, and exploratory spatial data analysis were adopted to study the temporal-spatial dynamic evolution characteristics of the HSE.

Results: The study found that China's HSE showed an average value of approximately 0.841, indicating room for improvement. The HSE varied significantly across regions, presenting an "East > Central > West" distribution layout. The TFP of healthcare services in China grew by 1.6% per year, driven mainly by technological progress of 1.8% per year. The trend of the HSE shifting to a high level in China was significant, but its evolution exhibited stability of maintaining the original state, and it was harder to achieve leapfrog transfer. The temporal-spatial evolution of the HSE was also significantly affected by geospatial factors, with a clear spatial spillover effect and spatial agglomeration characteristics. Provinces with high-level HSE exhibited positive spatial spillover effects, while provinces with low-level HSE had negative spatial spillover effects. Thus, the "club convergence" phenomenon of "high efficiency concentration, low efficiency agglomeration, high levels of radiation, and low levels of suppression" was formed in the spatial distribution.

Conclusions: The results indicate that countermeasures should be taken to improve the HSE in China. Theoretical support for the improvement of HSE is provided in this paper.