Total factor productivity of urban public hospitals in China based on provincial perspective

Objective: To calculate the total factor productivity (TFP) through the input-output indicators of medical services (2019-2021) of urban public hospitals in 31 provinces (excluding Hong Kong, Macao and Taiwan)in order to provide basis and suggestions for the future allocation and planning of urban medical and health re-sources in China.Methods: Based on the input and output data of medical services in 31 provinces from 2019 to 2021, the Bootstrap-Malmquist-DEA model was used to calculate the total factor productivity of public hospitals in cities of each province.Results: From 2019 to 2021, the change index of TFP of national urban public hospi-tals (TFPC) was 1.083, showing a slight increase in the three years as a whole, with a trend of first falling and then rising, and a central> western> eastern region; the national TFPC from 2019 to 2020 was 0.889, with an over-all slight decrease and a western> central> eastern region.From 2020 to 2021, the national TFPC was 1.216, with an overall slight increase and a central> eastern> western region.Conclusion: After the COVID-19 outbreak, Chi-na’s urban public hospitals’TFP of medical services experiences a decline and then an increase, and the growth level of TFP is not balanced among re-gions.Technological progress and technological ef-ficiency jointly affect the change level of TFP.Urban public hospitals should pay more attention to their own orga-nizational and management capacity building while expanding their scale.