摘要 : Objectives: We conducted a comparative analysis on the performance of 57 county public medical systems in Guangdong Province in 2014-2019 and tried to find out how vastly the performance differed across counties and what might cau... 展开 Objectives: We conducted a comparative analysis on the performance of 57 county public medical systems in Guangdong Province in 2014-2019 and tried to find out how vastly the performance differed across counties and what might cause these differences. Answers to these questions could serve as the basis for policymaking in the current reform of China's rural medical systems, helping policymakers to identify the inefficient counties and giving suggestions on possible further reformation of the rural medical system.Methods: Output-oriented SBM DEA models were employed to measure efficiency performance and a Tobit regression model was employed to explore determinants of efficiency.Results: The Pearl River Delta region had the most medical resources while the East region had the least. Average efficiency scores in 2014-2019 show a slight increase of around 1%, i.e., 0.798, 0.766, 0.781, 0.781, 0.779 and 0.802, respectively. 96.5% of counties experienced inefficiency problems and 36.8% of counties were worsened with declined score trends. Average efficiency scores in the Pearl River Delta region decreased mildly. Economic, government, and population factors were related to efficiency scores positively and significantly.Conclusions: Most county public hospitals experienced inefficiency problems and substantial regional disparities existed in Guangdong's county-level medical efficiency, which should be noticed by policymakers. Issues in the reform like insufficient revenues and government subsidies, higher surgical expenses, inadequate technology, and unbalanced regional policies may have hindered medical efficiency, which should be addressed in future reforms. 收起