Objective: To explore the service efficiency of public hospitals and its influencing factors, providing scientific evidence and policy suggestions to promote the sustainable development of the healthcare sector. Methods: The study selected public hospitals in 31 provincial-level administrative regions of China as the research objects, with data mainly sourced from the China Statistical Yearbook and China Health Statistics Yearbook, covering the period from 2013 to 2021. A three-stage DEA model was used to analyze the service efficiency of public hospitals. Input indicators included the number of practicing(assistant) physicians, the number of available hospital beds, and the number of public hospitals. Output indicators included the average length of hospital stay, the number of outpatient and emergency visits, and the number of hospital bed-days per physician per day. Environmental variables included regional per capita GDP, the proportion of regional government health expenditure in total health spending, the proportion of regional urban population, and the proportion of the regional elderly population. A Tobit model was applied to analyze the influencing factors of public hospital service efficiency. Results: The study found that service efficiency of public hospitals varied across regions. The efficiency scores for public hospitals in the Eastern, Central, Western, and Northeastern regions were 0.953, 0.911, 0.944, and 0.879, respectively. The physician-to-nurse ratio and the number of practicing(assistant) physicians per 1,000 people had a significant positive relationship with the service efficiency of public hospitals, with positive correlation coefficients of 0.002 and 0.016, respectively. In contrast, bed utilization rate showed a significant negative relationship with service efficiency, with a negative correlation coefficient of -0.001. Conclusion: By analyzing the service efficiency of public hospitals and its influencing factors, this study provides scientific evidence for addressing issues such as strained medical resources and imbalanced service quality in public hospitals. Future research could further explore how hospital management models and medical technology innovations impact service efficiency, thereby promoting the sustainable development of the healthcare sector. |