The Productive Efficiency of China's Health Care System and its Determinants——Evidence on Provincial Panel Data from 2003-2006

Using the panel data among Chinese 31 provinces from 2003 to 2009,this paper evaluates the dynamic change in the productive efficiency of China's health care system and its determinants by Malmquist-Tobit two stage method.Different from the existing studies,this paper,first includes the quality proxy into the Malmquist index,thus forming the quality adjusted Malmquist index and second,use the panel Tobit model to examine its determinants.The findings are: quality-adjusted Malmquist index is declining from 2003 to 2009.There is sharp difference among different regions and provinces.The determinants of Malmquist index includes ratio of for-profit in a province,average inpatient fee,hospital bed circulation rate and average length of stay.The policy implications are: in order to increase the productive efficiency of Chinese health care system,we must pay attention to the provinces with low efficiencies and optimize the governance of hospitals.