Abstract:

Since the new medical reform in 2009， China's healthcare sector has developed rapidly， with an increasing total amount of healthcare resources and a significant improvement in health level. However， there are also issues of low efficiency and significant regional imbalances in the health system. Based on geographical location， economic development level， and healthcare policy factors， China's healthcare exhibits typical regional characteristics in the eastern， central， and western regions. It is of great practical significance to study the heterogeneity of healthcare system technology levels and the efficiency imbalance in different regions.In this study， the health system efficiency is evaluated combining the non-radial directional distance function with the meta-frontier approach based on the classification of eastern， central and western regions. This method evaluates the meta-frontier efficiency， group frontier efficiency， and technology gap ratio of provinces in different regions from 2010 to 2019. On this basis， parametric and non-parametric methods are used to explore the convergence trends of health system efficiency and technology gap ratio. The data for this study are drawn from China Health Statistics Yearbook and the sample includes 31 provinces in China from 2010 to 2019.The results indicate that the eastern region is regarded as a technology leader， while the central and western regions are regarded as technology followers； There is no σ-convergence observed in the efficiency and technology gap ratio， indicating the provincial disparities have not narrowed， but there exists conditional β-convergence， indicating a convergence towards their respective steady-state levels over time； The health system efficiency and technology gap ratio exhibit a certain path dependence. Provinces with high efficiency values tend to have upward shifts， while provinces with medium and low efficiency exhibit some path dependence and show minimal changes. Significant upward shifts in technology gap ratios occur only at very low levels， and most technology gap ratios experience minimal variations. Therefore， the government should pay attention to the technological gap in the eastern， central， and western regions， strengthen the innovation in the central and western regions， and explore high-level convergence mechanisms for health system efficiency.

Key words: health system efficiency, meta-frontier, convergence test