Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (7): 81-89.doi: 10.6040/j.issn.1671-7554.0.2025.1256

• Public Health and Preventive Medicine • Previous Articles     Next Articles

Operational efficiency analysis of secondary public general hospitals in Shandong Province from 2014 to 2023 based on Global-Malmquist index

ZHANG Tianjiao1, LI Jingjing2, WANG Lijun3, SHAN Shirui1, LIU Keke1   

  1. 1. Infection Control Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    2. Discipline Inspection Commission Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    3. General Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    4. Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Online:2026-07-10 Published:2026-07-21

PDF (PC)

2

Abstract: Objective To analyze the changes in operational efficiency of secondary public general hospitals in Shandong Province, compare the efficiency differences among hospitals in different regions(the Provincial Capital Economic Circle, the Jiaodong Economic Circle, and the Lunan Economic Circle)of Shandong, and provide policy references for the differentiated development of secondary public general hospitals. Methods Panel data of secondary public general hospitals from 16 prefecture-level cities(Laiwu City was merged into Jinan City in 2019)and the three economic circles(the Provincial Capital Economic Circle, the Jiaodong Economic Circle, and the Lunan Economic Circle)in Shandong Province from 2014 to 2023 were collected. Input and output indicators were identified, and the Global-Malmquist index model based on the super-efficiency SBM model was used to analyze efficiency changes. Results From 2014 to 2023, the operational efficiency of secondary public general hospitals in Shandong Province increased from 0.948 to 1.320. The efficiency differences among the provincial capital, Jiaodong, and Lunan economic circles were small from 2014 to 2017 but became significant from 2018 to 2023. Among the 16 prefecture-level cities(excluding Laiwu), 15 showed an upward trend in operational efficiency, accounting for 93.75% of the total. Conclusion The operational efficiency of secondary public general hospitals in Shandong Province shows an upward trend but with large fluctuations. Efficiency is more significantly affected by technological changes. There are problems such as unbalanced development of regional technical efficiency and insufficient capacity in responding to major public health events. It is necessary to implement differentiated development strategies such as technological and institutional innovation and scale adjustment to promote the high-quality development of hospitals.

Key words: Secondary public general hospitals, Operational efficiency, Malmquist index model, Total factor productivity, Regional differences, Shandong Province

CLC Number: 

  • R19
[1] 檀旦, 任巍, 张丽华. 湖北省二级以上公立医院运营管理部门建设现状调研[J]. 卫生软科学, 2023, 37(5): 49-52. Tan Dan, Ren Wei, Zhang Lihua. Investigation on the current situation of departments of operations management of public hospitals above secondary level in Hubei Pro-vince[J]. Soft Science of Health, 2023, 37(5): 49-52.
[2] 国家卫生健康委员会, 国家中医药管理局.关于加强公立医院运营管理的指导意见[J]. 中华人民共和国国家卫生健康委员会公报, 2020(12): 193-196.
[3] Malmquist S. Index numbers and indifference surfaces[J]. Trab. Estad, 1953, 4: 209-242. DOI: 10.1007/BF03006863
[4] Färe R, Grosskopf S, Lindgren B, et al. Productivity changes in Swedish pharmacies 1980-1989: a non-parametric Malmquist approach[J]. J Prod Anal, 1992, 3(1-2): 85-101. DOI: 10.1007/BF00158770
[5] Cooper W W,Seiford L M, Tone K. Data envelopment analysis: a comprehensive text with models, applications, references and DEA-solver software[M]. 2nd ed. New York: Springer, 2007: 15-16.
[6] 龚超, 李凤芝, 赵宝伟, 等. 基于DEA-Malmquist的天津市三级公立医院运营效率评价研究[J]. 中国医院, 2022, 26(7): 32-36. Gong Chao, Li Fengzhi, Zhao Baowei, et al. Research on operation efficiency evaluation of Grade III public hospitals in Tianjin based on DEA-Malmquist[J]. Chinese Hospitals, 2022, 26(7): 32-36.
[7] 虞莉莎, 王全, 王梓萱, 等. 湖北省公立二级综合医院运营效率和影响因素分析[J]. 中国医药科学, 2023, 13(19): 148-151. Yu Lisha, Wang Quan, Wang Zixuan, et al. Analysis of operational efficiency and influencing factors of public secondary general hospitals in Hubei Province[J]. China Medicine and Pharmacy, 2023, 13(19): 148-151.
[8] 于洗河, 降海蕊, 张景茹, 等. 吉林省县级公立医院运行效率评价: 基于DEA-Malmquist指数模型[J]. 中国卫生经济, 2021, 40(12): 87-90. Yu Xihe, Jiang Hairui, Zhang Jingru, et al. Operational efficiency evaluation of county-level public hospitals in Jilin: based on DEA-malmquist index model[J]. Chinese Health Economics, 2021, 40(12): 87-90.
[9] 张玥. 基于Malmquist指数的天津市医院运行效率分析[J]. 中国卫生统计, 2019, 36(3): 375-376. Zhang Yue. Analysis of hospital operation efficiency in Tianjin based on malmquist index[J]. Chinese Journal of Health Statistics, 2019, 36(3): 375-376.
[10] 王春霞, 李娟, 贺梦璐, 等. 基于DEA-Malmquist指数的山东省三级公立医院运行效率分析[J]. 中国卫生事业管理, 2022, 39(8): 586-589. Wang Chunxia, Li Juan,He Menglu, et al. Operational efficiency analysis of tertiary public hospitals in Shandong Province based on DEA-malmquist index[J]. Chinese Health Service Management, 2022, 39(8): 586-589.
[11] 曹养栋, 时涛, 宫明, 等. 山东省79家三级综合医院资源配置效率研究[J]. 中国卫生经济, 2024, 43(12): 52-57. Cao Yangdong, Shi Tao, Gong Ming, et al. Study on the resource allocation efficiency of 79 tertiary general hospitals in Shandong Province[J]. Chinese Health Economics, 2024, 43(12): 52-57.
[12] 乔记兵, 张琦, 程琳, 等. 基于数据包络分析法的山东省县级公立医院服务效率分析[J]. 中国医院管理, 2025, 45(10): 88-91. Qiao Jibing, Zhang Qi, Cheng Lin, et al. Analysis of service efficiency of county-level public hospitals in Shandong Province based on data envelopment analysis method[J]. Chinese Hospital Management, 2025, 45(10): 88-91.
[13] 姜凤, 张珉, 陈永成, 等. 基于三阶段DEA模型和Malmquist指数的我国医院运营效率研究[J]. 中国医院, 2025, 29(5): 2-7. Jiang Feng, Zhang Min, Chen Yongcheng, et al. Research on hospital operational efficiency in China based on the three-stage DEA model and Malmquist index[J]. Chinese Hospitals, 2025, 29(5): 2-7.
[14] Wang Z, Li Z, Xie R. Regional disparities, dynamic evolution, and spatial spillover effects of medical resource allocation efficiency in TCM hospitals[J]. Cost Eff Resour Alloc, 2025, 23(1): 35. DOI: 10.1186/s12962-025-00644-6
[15] 孙波. 鄞州二院医共体医保基金管理整合的探索[J]. 财务与会计, 2025(2): 26-28.
[16] 张文天, 李慧, 孔凡悦, 等. 基于DEA-Malmquist指数模型的黄河流域医院运营效率研究[J]. 中国医院管理, 2022, 42(11): 14-17. Zhang Wentian, Li Hui, Kong Fanyue, et al. Research on hospital operation efficiency in the Yellow River Basin of China based on DEA-malmquist index model[J]. Chinese Hospital Management, 2022, 42(11): 14-17.
[17] 宋丽红, 赵要军, 李晨琪. 新型冠状病毒肺炎疫情对河南省公立医院经济运营的影响及应对策略探讨[J]. 中国医院管理, 2020, 40(8): 21-24. Song Lihong, Zhao Yaojun, Li Chenqi. Discussion on the countermeasures of the impact of COVID-19 epidemic on the economic operation of public hospitals in Henan Province[J]. Chinese Hospital Management, 2020, 40(8): 21-24.
[18] Mallipeddi N V, Chandra J, Succi M D. A strategy to incentivize innovation in the health care system: the innovation RVU[J]. Nat Biotechnol, 2023, 41: 1485-1487. DOI: 10.1038/s41587-023-01971-w
[19] 张义丹, 胡豫, 许栋, 等. 大型公立医院推进高质量发展的改革策略与路径选择[J]. 中国医院管理, 2022, 42(8): 1-5. Zhang Yidan, Hu Yu, Xu Dong, et al. Reform strategy and path choice of accelerating high-quality development in large public hospitals[J]. Chinese Hospital Management, 2022, 42(8): 1-5.
[20] 赵霞, 李小华. “十四五”期间医院信息化建设发展的若干思考[J]. 中国医院, 2021, 25(1): 64-66. Zhao Xia, Li Xiaohua. Thoughts on the development of hospital information construction during the “14th Five-Year Plan”[J]. Chinese Hospitals, 2021, 25(1): 64-66.
[21] 李亚娟, 郭培栋. 我国县级医院运行效率及空间自相关性分析[J]. 中国医院, 2023, 27(6): 22-25. Li Yajuan, Guo Peidong. Analysis of operational efficiency and spatial autocorrelation of county-level hospitals in China[J]. Chinese Hospitals, 2023, 27(6): 22-25.
[22] 段茂瑶, 胡琪尧, 姚魏紫, 等. 四川省县级公立综合医院医疗服务效率研究[J]. 中国医院管理, 2026, 46(1): 48-53. Duan Maoyao, Hu Qiyao, Yao Weizi, et al. Research on the medical service efficiency of county level public comprehensive hospitals in Sichuan Province[J]. Chinese Hospital Management, 2026, 46(1): 48-53.
[23] 闵锐, 周亚旭, 方鹏骞, 等. 贫困地区县级公立医院医疗服务能力发展现状及改进策略研究: 以三峡城市群县级公立医院发展为例[J]. 中国医院, 2017, 21(9): 16-19. Min Rui, Zhou Yaxu, Fang Pengqian, et al. The current situation and improvement strategy of healthcare capability of county-level public hospitals in poverty areas-a case study of county-level public hospitals in Three Gorges urban agglomeration[J]. Chinese Hospitals, 2017, 21(9): 16-19.
[24] 沈信姿, 吴素雄. 我国二级医院的发展困境与出路[J]. 中华医院管理杂志, 2021, 37(10): 864-867. Shen Xinzi, Wu Suxiong. Dilemma and outlet of the development of secondary hospitals in China[J]. Chinese Journal of Hospital Administration, 2021, 37(10): 864-867.
[25] 赖诗然, 谢军慧, 徐华. 基于DEA-Tobit法的广东省公立医院效率及其影响因素研究[J]. 中国社会医学杂志, 2024, 41(6): 758-762. Lai Shiran, Xie Junhui, Xu Hua. Study on the efficiency and influencing factors of public hospitals in Guangdong Province by DEA-Tobit method[J]. Chinese Journal of Social Medicine, 2024, 41(6): 758-762.
[26] 肖雪, 崔凤环, 王玥涵, 等. 山东省区域间三级公立医院高质量发展评估[J]. 健康发展与政策研究, 2025, 28(4): 379-385. Xiao Xue, Cui Fenghuan, Wang Yuehan, et al. Evaluation of high-quality development among tertiary public hospitals across regions in Shandong Province[J]. Health Development and Policy Research, 2025, 28(4): 379-385.
[27] Moin-ul-aziz H M, Azeem S F, Hanif S, et al. Cost control optimization strategies in hospital financial mana-gement: an empirical study based on Chinese hospitals[J]. Crit Rev Soc Sci Stud, 2025, 3(3): 332-350.
[28] 肖建春. 医保支付方式改革对公立医院运营管理的影响分析[J]. 现代商贸工业, 2024, 45(2): 184-187. Xiao Jianchun. Analysis on the impact of medical insurance payment method reform on operation and management of public hospitals[J]. Modern Business Trade Industry, 2024, 45(2): 184-187.
[29] 张楠. 公立医院全面预算管理一体化建设研究[J]. 卫生经济研究, 2026, 43(5): 89-93. Zhang Nan. Research on integrated construction of comprehensive budget management in public hospitals[J]. Health Economics Research, 2026, 43(5): 89-93.
[30] 龚致富, 李振良, 姬静怡, 等. 突发公共卫生事件背景下综合医院提升应急管理能力策略探析[J]. 中国医学伦理学, 2024, 37(10): 1175-1180. Gong Zhifu, Li Zhenliang, Ji Jingyi, et al. Exploration of strategies for enhancing emergency management capabilities in general hospitals under the background of public health emergencies[J]. Chinese Medical Ethics, 2024, 37(10): 1175-1180.
[31] 柯丹丹, 贾楠, 崔埔安, 等. 后疫情时代我国基层医疗卫生服务发展现状、挑战及建议[J]. 协和医学杂志, 2024, 15(1): 45-51. Ke Dandan, Jia Nan, Cui Puan, et al. Current situation, challenges and suggestions for the development of primary health care services in China in the post pandemic era[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(1): 45-51.
[32] 冯毅, 张青峰, 魏来. 突发重大公共卫生事件背景下贵州省医疗资源供给与配置创新目标探索[J]. 中国卫生经济, 2023, 42(6): 63-65. Feng Yi, Zhang Qingfeng, Wei Lai. Research on innovation of supply and allocation of medical resources in Guizhou in the context of major public health emergency[J]. Chinese Health Economics, 2023, 42(6): 63-65.
[33] 张世翔, 黄天翔. 突发公共卫生事件下有效推进分级诊疗的实施策略研究[J]. 中国医院, 2023, 27(8): 22-25. Zhang Shixiang, Huang Tianxiang. Research on implementation strategies for effectively promoting hierarchical medical treatment under major public health emergencies[J]. Chinese Hospitals, 2023, 27(8): 22-25.
[34] 孙梦, 张宏远, 宋琪琪, 等. 某传染病医院应急管理能力现状分析及提升策略研究[J]. 中国医疗管理科学, 2025, 15(1): 128-134. Sun Meng, Zhang Hongyuan, Song Qiqi, et al. Analysis on current situation and improvement strategies of emergency management capacity in an infectious disease hospital[J]. Chinese Journal of Medical Management Sciences, 2025, 15(1): 128-134.
[35] 张良, 金艳红, 李秀典, 等. 医防融合背景下公立医院应急管理体系建设探析[J]. 中国医院管理, 2025, 45(12): 101-104. Zhang Liang, Jin Yanhong, Li Xiudian, et al. Analysis on the construction of emergency management system in public hospitals under the background of integration of medical treatment and prevention[J]. Chinese Hospital Management, 2025, 45(12): 101-104.
[36] 宋旭生, 蒋筠, 李莹莹. 公立医院应急管理能力提升路径研究[J]. 中国医院, 2025, 29(11): 39-41. Song Xusheng, Jiang Yun, Li Yingying. Research on improvement paths of emergency management capacity in public hospitals[J]. Chinese Hospitals, 2025, 29(11): 39-41.
[1] PANG Jinhong, SU Ping, QIAO Junpeng, CHEN Qiaoqiao, CHEN Xueyu, ZHAO Yingying, SHI Jie, SUN Xiaoru, LI Qiuchun, HE Ruiyan, FAN Yiou, CHI Weiwei. Association between modifiable cardiovascular risk factors clustering patterns and stroke in the elderly population [J]. Journal of Shandong University (Health Sciences), 2025, 63(9): 11-19.
[2] Thoracoscopic Committee of Shandong Provincial Endoscopic Surgery Quality Control Center. Shandong Provincial expert consensus on control indexes of VATS/RATS perioperative quality for non-small cell lung cancer [J]. Journal of Shandong University (Health Sciences), 2025, 63(12): 1-5.
[3] . Shandong Province expert consensus on multidisciplinary treatment of breast cancer(2024 edition) [J]. Journal of Shandong University (Health Sciences), 2025, 63(1): 10-16.
[4] WANG Jiongjiong, WANG Guoyong, ZHU Xiaoyan, LI Ling, ZHANG Na, LIU Yunxia. Immediate antiretroviral treatment in 1,926 cases of HIV infection through homosexual transmission in Shandong Province [J]. Journal of Shandong University (Health Sciences), 2023, 61(1): 100-105.
[5] SUN Yifeng, LI Wei, SUN Shiying, GU Anman, TAN Shengnan, FU Xunye, WANG Haizhi, JI Jianfen, GUAN Yuwang, WU Xiangqian, HE Zhicheng, WEN Zhaoyang, YU Shangjia, LI Shiyi, LIU Xinghong, CHEN Ying, WANG Tingting, SUN Yundong. Changes of antibiotic resistance rates of Morganella morganii in 11 regions of Shandong Province from 2016 to 2021 [J]. Journal of Shandong University (Health Sciences), 2022, 60(12): 88-93.
[6] CAO Aihua, DUAN Chunhong, QIU Bingping, LU Ling, LI Keliang, LIU Xuegong, ZHOU Zhiyuan, SUN Jianhua, JU Xiuli. Epidemiological and clinical characteristics of children infected with SARS-CoV-2 in Shandong Province [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 34-40.
[7] ZHOU Shengyu, WANG Chunting, ZHANG Wei, WANG Ximing, DONG Liang. Clinical characteristics and treatment effect of 537 cases of novel coronavirus pneumonia in Shandong Province [J]. Journal of Shandong University (Health Sciences), 2020, 58(3): 44-51.
[8] LIU Guanyi, YANG Liyuan, FU Zhentao, XU Aiqiang, GUO Xiaolei. Incidence and mortality of oral cancer in Shandong Province in 2014 [J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 102-107.
[9] HE Dongyang, SUN Jiyao, WANG Meng, WANG Jian, HUANG Guo. Comparison of the characteristics of inpatients’ disease distribution in a tertiary hospital in Shandong Province in 2006 and 2016 [J]. Journal of Shandong University (Health Sciences), 2018, 56(4): 81-86.
[10] ZHAO Qingqing, YIN Geping. Association between genetic polymorphisms of 5 genetic loci of TNF-α promoter and genetic susceptibility to cervical cancer [J]. Journal of Shandong University (Health Sciences), 2018, 56(2): 28-33.
[11] WANG Meijian, HOU Xinguo, LIANG Kai, CHEN Li. Serum lipids and lipoproteins in middle-aged and elderly Chinese in Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 70-75.
[12] YANG Ding,YANG Peng, LI Yubo, SUN Qiang. Changes in prescriptions for upper respiratory tract infections in Z county of Shandong Province:a panel data analysis of 8 village clinics [J]. Journal of Shandong University (Health Sciences), 2017, 55(12): 88-94.
[13] LI Yan, LIU Kun, SUN Xiaojie. Health inequality related to income and influencing factors of the rural elderly in three counties of Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(6): 91-96.
[14] WANG Xing, ZHANG Xiyu, LIN Weiwei, LIAN Ying, ZHANG Qingqing, LI Qilong, LI Shixue. Present situation and existing problems of telemedicine in Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(2): 90-94.
[15] CHEN Si, WANG Muchuan, REN Nannan, XU Wei, WANG Lingling, LUAN Haihui, MA Jun, LIU Yiming. Relationship between polymorphisms of Parkin gene and the risk of Parkinson's disease in Han nationality of Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(4): 71-74.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd