{"id":"https://openalex.org/W7224086028","doi":"https://doi.org/10.1186/s12913-026-15957-2","title":"Operational efficiency of clinical departments under DRG-based payment: a super-SBM model with undesirable outputs and quantile regression analysis","display_name":"Operational efficiency of clinical departments under DRG-based payment: a super-SBM model with undesirable outputs and quantile regression analysis","publication_year":2026,"publication_date":"2026-10-28","ids":{"openalex":"https://openalex.org/W7224086028","doi":"https://doi.org/10.1186/s12913-026-15957-2"},"language":"en","primary_location":{"id":"doi:10.1186/s12913-026-15957-2","doi":"https://doi.org/10.1186/s12913-026-15957-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12913-026-15957-2","pdf_url":null,"source":{"id":"https://openalex.org/S12898181","display_name":"BMC Health Services Research","issn_l":"1472-6963","issn":["1472-6963"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Services Research","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12913-026-15957-2","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5130667751","display_name":"Xiaoyi He\u00b9","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaoyi He","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160050869","display_name":"Laoqi Liang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Laoqi Liang","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160005854","display_name":"Xinfeng Zhou","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Xinfeng Zhou","raw_affiliation_strings":["Shenzhen Xinhua Hospital, Shenzhen, Guangdong Province, 518110, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Shenzhen Xinhua Hospital, Shenzhen, Guangdong Province, 518110, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052987214","display_name":"Feng Chen","orcid":"https://orcid.org/0000-0003-4800-6762","observed_orcids":["https://orcid.org/0000-0003-4800-6762"]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Feng Chen","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130659278","display_name":"Zhitao He\u00b9","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Zhitao He","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130693847","display_name":"Yajuan Qiao\u00b9","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yajuan Qiao","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130648351","display_name":"Zhicong Yao\u00b9","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Zhicong Yao","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5130645766","display_name":"Wenxia You\u00b9","orcid":"https://orcid.org/0009-0007-9339-4668","observed_orcids":["https://orcid.org/0009-0007-9339-4668"]},"institutions":[{"id":"https://openalex.org/I4210098425","display_name":"The First People's Hospital of Shunde","ror":"https://ror.org/00wwb2b69","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210098425"]},{"id":"https://openalex.org/I58200834","display_name":"Southern Medical University","ror":"https://ror.org/01vjw4z39","country_code":"CN","type":"education","lineage":["https://openalex.org/I58200834"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Wenxia You","raw_affiliation_strings":["The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China"],"raw_orcid":"https://orcid.org/0009-0007-9339-4668","affiliations":[{"raw_affiliation_string":"The Eighth Affiliated Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde, Foshan), Foshan, Guangdong Province, 528300, China","institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5130645766"],"corresponding_institution_ids":["https://openalex.org/I4210098425","https://openalex.org/I58200834"],"apc_list":{"value":3290,"currency":"USD","value_usd":3290},"apc_paid":{"value":3290,"currency":"USD","value_usd":3290},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.8439646,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10357","display_name":"Efficiency Analysis Using DEA","score":0.9922000169754028,"subfield":{"id":"https://openalex.org/subfields/1803","display_name":"Management Science and Operations Research"},"field":{"id":"https://openalex.org/fields/18","display_name":"Decision Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10357","display_name":"Efficiency Analysis Using DEA","score":0.9922000169754028,"subfield":{"id":"https://openalex.org/subfields/1803","display_name":"Management Science and Operations Research"},"field":{"id":"https://openalex.org/fields/18","display_name":"Decision Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.0020000000949949026,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.0017999999690800905,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/clinical-departments","display_name":"clinical departments","score":0.574999988079071},{"id":"https://openalex.org/keywords/operational-efficiency","display_name":"operational efficiency","score":0.6809999942779541},{"id":"https://openalex.org/keywords/super-sbm-model","display_name":"Super-SBM model","score":0.6990000009536743},{"id":"https://openalex.org/keywords/undesirable-outputs","display_name":"undesirable outputs","score":0.9929999709129333},{"id":"https://openalex.org/keywords/quantile-regression","display_name":"quantile regression","score":0.9559999704360962},{"id":"https://openalex.org/keywords/hospital-performance","display_name":"hospital performance","score":0.6179999709129333},{"id":"https://openalex.org/keywords/data-envelopment-analysis","display_name":"data envelopment analysis","score":0.5709999799728394}],"concepts":[{"id":"https://openalex.org/C145642194","wikidata":"https://www.wikidata.org/wiki/Q870895","display_name":"Health informatics","level":3,"score":0.6965000033378601},{"id":"https://openalex.org/C137992405","wikidata":"https://www.wikidata.org/wiki/Q1137608","display_name":"Health administration","level":3,"score":0.6669999957084656},{"id":"https://openalex.org/C63817138","wikidata":"https://www.wikidata.org/wiki/Q3455889","display_name":"Quantile regression","level":2,"score":0.6470999717712402},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.5188000202178955},{"id":"https://openalex.org/C518773536","wikidata":"https://www.wikidata.org/wiki/Q918533","display_name":"Nursing research","level":2,"score":0.44200000166893005},{"id":"https://openalex.org/C149782125","wikidata":"https://www.wikidata.org/wiki/Q160039","display_name":"Econometrics","level":1,"score":0.43050000071525574},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.42730000615119934},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4004000127315521},{"id":"https://openalex.org/C2778964270","wikidata":"https://www.wikidata.org/wiki/Q7097774","display_name":"Operational efficiency","level":2,"score":0.3937000036239624},{"id":"https://openalex.org/C524218345","wikidata":"https://www.wikidata.org/wiki/Q31218","display_name":"Health economics","level":3,"score":0.3578999936580658},{"id":"https://openalex.org/C2778091340","wikidata":"https://www.wikidata.org/wiki/Q15749950","display_name":"Quality of Life Research","level":3,"score":0.357699990272522},{"id":"https://openalex.org/C105795698","wikidata":"https://www.wikidata.org/wiki/Q12483","display_name":"Statistics","level":1,"score":0.3546000123023987},{"id":"https://openalex.org/C43214815","wikidata":"https://www.wikidata.org/wiki/Q7310987","display_name":"Reliability (semiconductor)","level":3,"score":0.33869999647140503},{"id":"https://openalex.org/C83546350","wikidata":"https://www.wikidata.org/wiki/Q1139051","display_name":"Regression","level":2,"score":0.326200008392334},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.3149000108242035},{"id":"https://openalex.org/C22088475","wikidata":"https://www.wikidata.org/wiki/Q647974","display_name":"Data envelopment analysis","level":2,"score":0.2937999963760376},{"id":"https://openalex.org/C48921125","wikidata":"https://www.wikidata.org/wiki/Q10861030","display_name":"Linear regression","level":2,"score":0.290800005197525},{"id":"https://openalex.org/C118671147","wikidata":"https://www.wikidata.org/wiki/Q578714","display_name":"Quantile","level":2,"score":0.2578999996185303}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1186/s12913-026-15957-2","doi":"https://doi.org/10.1186/s12913-026-15957-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12913-026-15957-2","pdf_url":null,"source":{"id":"https://openalex.org/S12898181","display_name":"BMC Health Services Research","issn_l":"1472-6963","issn":["1472-6963"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Services Research","raw_type":"journal-article"},{"id":"doi:10.21203/rs.3.rs-9102857/v1","doi":"https://doi.org/10.21203/rs.3.rs-9102857/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-9102857/v1","pdf_url":"https://www.researchsquare.com/article/rs-9102857/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.1186/s12913-026-15957-2","doi":"https://doi.org/10.1186/s12913-026-15957-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12913-026-15957-2","pdf_url":null,"source":{"id":"https://openalex.org/S12898181","display_name":"BMC Health Services Research","issn_l":"1472-6963","issn":["1472-6963"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Services Research","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9537000060081482}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7224086028.pdf","grobid_xml":"https://content.openalex.org/works/W7224086028.grobid-xml"},"referenced_works_count":3,"referenced_works":["https://openalex.org/W2506753585","https://openalex.org/W2963939215","https://openalex.org/W4386493430"],"related_works":["https://openalex.org/W3048755217","https://openalex.org/W2012221750","https://openalex.org/W3083132585","https://openalex.org/W2415961553","https://openalex.org/W3035726861","https://openalex.org/W7009678368","https://openalex.org/W2805114425","https://openalex.org/W7010349687","https://openalex.org/W3038993212","https://openalex.org/W4300830199"],"abstract_inverted_index":{"Abstract":[0],"Objective":[1],"This":[2,77],"study":[3,255],"aims":[4],"to":[5,97,283,298],"scientifically":[6],"assess":[7],"the":[8,36,43,74,99,163,281,296],"operational":[9,203],"efficiency":[10,54,85,116,125,131,249],"of":[11,38,102,166,175,192],"40":[12],"clinical":[13],"departments":[14,119],"in":[15,20,139,207],"a":[16,25,52,58,257],"Grade-A":[17],"tertiary":[18],"hospital":[19,72,273],"Foshan":[21],"during":[22],"2024,":[23],"with":[24,35,86,122,201,237,251],"focus":[26],"on":[27,108],"how":[28],"resource":[29,140,292],"allocation":[30],"and":[31,105,129,142,151,157,188,225,243,275,301],"service":[32,143,241],"delivery":[33,304],"align":[34],"goals":[37],"equitable,":[39,300],"high-quality":[40],"healthcare":[41,303],"under":[42,305],"Diagnosis-Related":[44],"Groups":[45],"(DRG)":[46],"payment":[47],"system.":[48],"Methods":[49],"We":[50],"developed":[51],"department-level":[53],"evaluation":[55],"framework":[56,259],"using":[57],"super-efficiency":[59],"Slack-Based":[60],"Measure":[61],"(SBM)":[62],"model":[63,93],"that":[64,172,268],"explicitly":[65],"accounts":[66],"for":[67,137,272],"undesirable":[68],"outputs\u2014such":[69],"as":[70],"prolonged":[71],"stays\u2014within":[73],"DRG":[75,212],"context.":[76],"approach":[78],"reflects":[79],"public":[80],"health":[81,276],"concerns":[82],"about":[83],"balancing":[84],"care":[87],"quality.":[88],"A":[89],"Tobit":[90,169],"censored":[91],"regression":[92,170],"was":[94,120],"then":[95],"applied":[96],"identify":[98],"marginal":[100],"effects":[101],"key":[103],"input":[104,208,286],"output":[106],"indicators":[107],"departmental":[109],"efficiency.":[110,168],"Results":[111],"The":[112,278],"mean":[113],"overall":[114],"technical":[115,124,167],"(OTE)":[117],"across":[118],"0.85,":[121],"pure":[123],"(PTE)":[126],"at":[127,133],"0.94":[128],"scale":[130],"(SE)":[132],"0.92,":[134],"indicating":[135],"room":[136],"improvement":[138],"utilization":[141],"organization.":[144],"Pediatric":[145],"Surgery":[146,153],"(PTE":[147,154,159],"=":[148,155,160,179,196,231],"2.21),":[149],"Oral":[150],"Maxillofacial":[152],"1.64),":[156],"Neonatology":[158],"1.61)":[161],"demonstrated":[162],"highest":[164],"levels":[165],"revealed":[171],"higher":[173],"numbers":[174],"nurses":[176],"(":[177,184,194,214,221,229],"P":[178,185,195,215,222,230],"0.02),":[180],"greater":[181],"bed":[182],"capacity":[183],"<":[186,216,223],"0.001),":[187,217,224],"longer":[189],"average":[190],"length":[191],"stay":[193],"0.03)":[197,232],"were":[198],"significantly":[199],"associated":[200],"lower":[202],"efficiency\u2014suggesting":[204],"potential":[205],"inefficiencies":[206],"scaling.":[209],"Conversely,":[210],"total":[211],"weight":[213],"Case":[218],"Mix":[219],"Index":[220],"annual":[226],"outpatient":[227],"visits":[228],"showed":[233],"significant":[234],"positive":[235],"associations":[236],"efficiency,":[238],"reflecting":[239],"stronger":[240],"complexity":[242],"population":[244],"reach.":[245],"Conclusions":[246],"By":[247],"integrating":[248],"measurement":[250],"driver":[252],"analysis,":[253],"this":[254],"proposes":[256],"closed-loop":[258],"\u201cefficiency":[260],"assessment":[261],"-":[262,265],"determinant":[263],"identification":[264],"targeted":[266],"optimization\u201d":[267],"provides":[269],"actionable":[270],"insights":[271],"administrators":[274],"policymakers.":[277],"findings":[279],"underscore":[280],"need":[282],"move":[284],"beyond":[285],"expansion":[287],"toward":[288],"smarter,":[289],"more":[290],"responsive":[291],"deployment,":[293],"thereby":[294],"supporting":[295],"transition":[297],"intensive,":[299],"sustainable":[302],"China\u2019s":[306],"DRG-based":[307],"reform":[308],"agenda.":[309]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-10-29T00:00:00"}