Healthcare System Capacity, Efficiency and Obstacles Since China's 2009 Reform: An Integrated Time-Series Assessment of Regional Disparities

Abstract

Background: In 2009, China launched a new round of healthcare reform. This study aims to comprehensively evaluate the service capacity and efficiency of the Chinese healthcare system at both the national and regional levels since the reform’s inception.

Methods: We collected ten indicators of healthcare service capacity and efficiency from the China Health and Family Planning Statistical Yearbook and the China Health Statistical Yearbook for the period 2009-2023. This study employs the entropy weight method and the obstacle degree model in an integrated approach to comprehensively evaluate performance and diagnose the specific obstacles that constrain it.

Results: Over the 16 years since the healthcare reform, the levels of healthcare service capacity and efficiency have generally shown an upward trend at the national level and across the eastern, central, and western regions. Specifically, the highest performance was observed in 2023, while the lowest was recorded in 2009. The main factors influencing healthcare service capacity and efficiency in China were identified as Inpatient Surgeries, Health Personnel, Hospital Beds, Medical Institutions, Average Length of Stay, and Total Patient Visits. However, the specific obstacle factors varied marginally among the national, eastern, central, and western regions.

Conclusions: Based on our comprehensive evaluation, it has been confirmed that healthcare service capacity and efficiency in China have demonstrated a pattern of gradual improvement since the 2009 healthcare reform. However, against the backdrop of ongoing socioeconomic development, demographic shifts, and other influencing factors, the Chinese government should continue to enhance healthcare capacity and efficiency nationwide to address the trend of diversifying future healthcare demands.