Research on Healthcare Service Efficiency in Anhui Province Based on the Three-Stage DEA and GM Index

The gradual implementation of the DRG/DIP payment reform strategy aims to enhance the quality and efficiency of healthcare institutions and promote high-quality development of the healthcare insurance system. Since the pilot program officially began in 2019, several cities in Anhui Province have been progressively included in the DRG/DIP pilot. To scientifically assess healthcare service efficiency in Anhui Province, this study selects 16 cities from 2017 to 2022 as decision-making units and employs a three-stage DEA-GM model for efficiency evaluation, measuring healthcare service efficiency and its dynamic changes under a global reference framework.The study findings indicate that the average initial comprehensive efficiency of the 16 cities from 2017 to 2022 was 0.961, with most cities exhibiting decreasing returns to scale. After accounting for environmental variables and random disturbances, the adjusted average comprehensive efficiency increased to 0.972, with most cities showing increasing returns to scale. Growth in per capita GDP positively affects the utilization of healthcare resources, while population density has a significant negative impact on healthcare fund investment. Increased government healthcare expenditure tends to suppress the utilization of medical resources, reflecting inefficiencies in fund use and management. The dynamic Malmquist index results show that technological progress is the primary factor contributing to the overall decline in total factor productivity in Anhui Province.