【正文】 a cautious monitoring of quality is required. In Qianjiang of Chongqing, global budget is used in addition to implementingcasebased payment with positive results. Since 2020, the Bureau of National Health Insurance (BNHI) in Taiwan has been implementing a specific 濟(jì)南大學(xué)畢業(yè) 論文外文資料翻譯 11 approach to GBS, called ―Selfmanagement project‖ (SMP), with useful results if the Weifang authorities bee interested in GBS. The aim of SMP is to help to increase the efficiency of healthcare resource utilization and to control the growth of healthcare expenditures under GBS. BNHI conducts annual evaluations of hospital activities to determine the level (and growth rate) of yearly service quantity that it will offer the individual hospital for the next contractual year. Dissatisfied with the BNHI, the hospital may require a reevaluation of its performance and needs. In both cases, it will be pushed to try to convince BNHI that it needs more resources. A recent study by Yan, Hsu, Yang, and Fang (2020) shows that the issue of accurate information that we have emphasized above is crucial. 6. Conclusion During the last ten years, China has undertaken major health reforms tha。 Juncheng, 2020). Then the health authorities in Weifang should push the NRCMS to bee active health care purchasers through contracting, instead of being more or less passive payers. That means that the regulator has to do what is necessary to give the THs and NRCMS in Weifang sufficient skill and ability to fairly negotiate prices,quality and quantity of services. This is a promising but challenging road ahead. . Lets THs managers manage Competition, contracts and financial discipline cannot drastically change THs39。 perceived quality of care. But the point and the concern, both for hospitals39。 Harding, 2020), creating a hard or a ―soft budget constraint‖ (SCB). As pointed out by Kornai (2020) (p. 119–120), SBC is ―not a single event, (…) but a mental condition, present in the head—the thinking, the perception of a decision maker (…). There are grades of ha rdness and softness‖. That means that indicators should be continuous, not discrete. Theoretical and empirical literatures provide us with some evidence showing that SBC can decrease efficiency. Regarding THs, one of the most important factors of budget constraint es from the current share of subsidies in total expenditures (excluding staff related expenditures), rather than from the deficit, as the deficit implies a kind of informal ―agreement‖ (the so called ―guanxi‖) between each TH, the health authorities and local municipalities. Therefore, a high proportion of subsidies may have a negative effect on efficiency as they lower the financial constraint of THs, creating a ―soft budget constraint‖. 濟(jì)南大學(xué)畢業(yè) 論文外文資料翻譯 7 Selecting the current amount of subsidies (ratio), instead of the lagged one, is relevant because the volume of subsidies cannot be anticipated by the TH as it is decided at the beginning of the year. We then also take into consideration the potential effect that the efficiency of a TH in a specific production process (for example, in curative healthcare delivery) can also have an effect on the efficiency of this same TH in other production processes (for example, in preventive healthcare delivery). To assess cross services39。Neill et al.(2020), and Hollingsworth et al. (1999) in spite of its limitations. One is that the technical efficiency obtained from this method does not give information on the quality of services, nor does it reflect the needs of patients. This being said, one essential assumption on our sample THs being the existence of underutilization of resources, this implies that, in general terms, increasing the volume of THs39。 Seiford, 1994。 Hu et al., 2020), stressing the importance of investigating more at local level through case studies to deepen knowledge and guide specific regional policies, as mentioned by Eggleston et al. (2020). A twostage approach is applied: technical efficiency of THs is puted fromDEA and then technical efficiency scores are regressed on a set of explanatory variables through a Tobit approach. 2. Data The original dataset covers 24 randomly selected THs of Weifang Prefecture, in Shandong Province (about 14% of total THs in Weifang Prefecture) observed over a nineyear period, from 2020 to 2020. Information was collected from the Weifang Health Bureau database and the registers/books of the THs during the third quarter of 2020 in collaboration with the Weifang Medical University and Chinese authorities. Data were checked and when necessary new investigations were implemented in THs and pleted 濟(jì)南大學(xué)畢業(yè) 論文外文資料翻譯 4 with interviews. The size of the THs is relatively small with on average 39 beds, 45 curative medical staff and six preventive staff over the , the number of beds varied from16 to 150, reflecting large disparities in the size of THs. The dataset consists of nine central THs and 15 general THs. Overall, the size of THs, as measured by the human and physical resources available, increased over the period. 3. Technical efficiency . Estimation of technical efficiency Developed in 1957 by Farrell (1957), the concept of technical efficiency refers to the capacity of a decision making unit (DMU) to transform a quantity of inputs into an amount of outputs. The technical efficiency of DMUs is studied through the framework of the efficiency frontiers (F248。 Liu et al., 2020), but never studied through an efficiency analysis. National studies revealed serious discrepancies throughout China, both in terms of the effects of reformand the functioning of the healthcare system (Brown, de Brauw, amp。 Chang, Cheng, amp。 Zhang, 2020). The second one is to make the THs, which suffered from the economic liberalization, more attractive by reorientating patients toward this level.