The impact of digital economy on primary healthcare institution efficiency: evidence from China based on spatial effect analysis

The digital economy (DE) in China has expanded rapidly in recent years. Information and communication technology, such as telemedicine and electronic medical records, has been used in primary healthcare institutions (PHCIs). This study explores the spatial effect of the DE on PHCI efficiency and analyzes the moderating role of institutional healthcare resources and capacity-based healthcare resources in the relationship between the DE and PHCI efficiency. Based on provincial statistical data of China from 2010 to 2022, this study uses a Meta-frontier Super-SBM model and the entropy weight method to measure PHCI efficiency and the level of the DE. The spatial effect models are used for the empirical analysis of the spatial effects and moderating effects of DE on PHCI efficiency. In addition, further heterogeneity analyses are conducted for different types of PHCIs. The results reveal that (1) the influence of DE on PHCI efficiency exerts a significant short-term inhibitory effect but transforms into a substantial long-term promotional effect, while also demonstrating a clear positive spatial spillover. (2) Institutional healthcare resources (e.g., high-level healthcare institutions) intensify the short-term negative impact but foster long-term gains, whereas capacity-based healthcare resources (e.g., primary healthcare human capital) provide positive short-term moderation, an effect that diminishes over time. (3) Significant heterogeneity exists across PHCI types. Policymakers should recognize the phased impact and spatial spillover effect of DE on PHCI efficiency. Meanwhile, they should also attach importance to the role of institutional healthcare resources and capacity-based healthcare resources in advancing the digital transformation of PHCIs. In addition, precise measures should be developed and implemented for different types of PHCIs.