Health expenditure efficiency in rural China using the super-SBM model and the Malmquist productivity index

BACKGROUND: Health expenditure efficiency (HEE) is an important research area in health economics. As a large agricultural country, China is faced with the daunting challenge of maintaining equality and efficiency in health resource allocation and health services utilization in the context of rapid economic growth in rural areas. The reasonable allocation of limited rural health resources may be achieved by scientifically measuring the current rural HEE. This subject may help to formulate effective policy or provide incentives for the health sector. METHODS: The combination of a super-slack-based measure (SBM) model with the Malmquist productivity index (MPI) is proposed to evaluate the static health expenditure efficiency (HEE) and dynamic health expenditure efficiency (DHEE) in rural China from 2007 to 2016. RESULTS: The results show that the HEE and DHEE values exhibit unstable trends over time. The HEE does not follow China’s economic development and presents an average of 0.598 (< 1); and the DHEE presents an average value of approximately 0.949 (< 1), indicating that the DHEE of most provinces is not moving in a desirable direction. The level of technological progress and scale optimization are the main factors hindering total factor productivity (TFP) growth. CONCLUSIONS: The Chinese government could improve the efficiency of rural health resources allocation by improving the rural health service system, optimizing the allocation of material resources and enhancing the level of health of financial resources allocation. The state should continue to moderate policy for different regions. Moreover, scientific and technological advancements should be introduced to improve the scale optimization levels.