Maternal and child health hospital services efficiency in rural China (2012–2021): a two-stage meta-frontier slack-based measure Tobit model

In recent years, China’s birth and marriage rates have continued to decline. Maternal and child health (MCH) hospitals are specialized healthcare institutions dedicated to the well-being of pregnant women, mothers, infants, and young children. Research on the efficiency of these hospitals’ services merits attention. Meanwhile, social and environmental factors, including education level, are also key indicators affecting efficiency. Thus, this study assesses the healthcare service efficiency of MCH hospitals in rural areas of China from 2012 to 2021. A data envelopment analysis and global Malmquist index have been applied to estimate the service efficiency of these hospitals. Furthermore, a Tobit analysis was used to examine the relationship between efficiency, birth rate, marriage, and other factors. The study established four critical points. First, the average efficiency of MCH hospitals in rural China consistently decreased. Second, although not true for the Northeast, the efficiency gaps between the Eastern, Central, and Western regions narrowed. Third, changes in total-factor productivity primarily depended on technological advancements. Fourth, birth rate, marriage, and the level of education have a significantly positive impact on service efficiency. The study recommends that MCH hospitals should match supply and demand and strengthen their service innovation. Governments should implement policies to improve human capital.