【正文】 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。 welfare, are that the real quality of care is hardly observable by patients in any health care system. Therefore a policy emphasizing strong petition among THs, village health stations and county hospitals to attract individual patients would be an adventurous dead end because of the quasi insoluble problems of multi directional asymmetry of information. After one short period of improvement of efficiency, it is thus more than likely that old problemswill crop up again with a worsening of health care quality. This being said, it does not mean that there is no efficiency gain to expect in organizing a controlled petition among health care providers to attract patients in Weifang. But it needs to be explored with great pragmatism and caution. In contrast, organizing providers (THs) to pete for contracts with well informed purchasers (NRCMS) seems to be apromising approach to promoting incentives to deliver good quality of care while improving efficiency (cf. for example Preker amp。 Rosenman, 2020。 Schmidt, 1980). The parametric stochastic approach, Stochastic Frontier Analysis (SFA) and the nonparametric determinist approach, Data Envelopment Analysis (DEA) are the most employed methods in production frontier analysis literature. The first is used when the production technology is wellknown. It is based on an econometric specification of the production technology, for which the shape is determined by microeconometric theory. The second is based on a mathematical linear program paring decision making units with each other in order to draw an efficiency frontier and pute efficiency scores. Considering hospitals, their optimization behavior diverges from traditional neoclassical theory (Hollingsworth, Dawson, amp。 Yang, 2020。 World Bank, 1997). The collapse of the CMS disturbed the referral system. Moreover, as THs suffered from a bad reputation, patients bypassed them to go directly to county hospitals (World Bank, 1997). This phenomenon was enhanced by the increase of rural ines, leading patients to look for higher quality services and enhancing their capacity to pay for health (Liu et al., 1996). Thus,the activity of THs fell off. Since 2020, the implementation of the New Rural Cooperative Medical Scheme (NRCMS) has served mainly two first one is to offer an insurance system to the rural population, in order to lower the financial barrier to accessing the healthcare system and to improve the rural population39。 Liu, Rao, amp。 Shen, 1996). THs constitute the intermediate level of healthcare facilities and ensure the link between village health stations at the grassroots level and county or abovelevel hospitals. They supervise healthcare delivery at the level of village health stations, and act as gate keepers, orienting patients toward higher health facility levels. They offer a wideranging set of general medical services by delivering curative and preventive activities, from 濟(jì)南大學(xué)畢業(yè) 論文外文資料翻譯 2 vaccinations and laboratory tests to outpatient visits and inpatient care. The Chinese rural healthcare system has greatly changed since the 1950s. From 1950 to 1975, China achieved significant improvements in health outes, thanks to the definition of an efficient threetier system of healthcare delivery and a successful munitybased rural health insurance scheme (Hsiao, 1995。 Liu et al., 1996). As a consequence, negative externalities came to light: the quality of healthcare declined, healthcare prices increased, expensive technologies were overused, drugs were overprescribed, the average length of stay increased and preventive activities were neglected to privilege expensive curative activities (Eggleston, Ling, Qingyue, Lindelow, amp。 efficiency is crucial, with regard to their strategic position in the healthcare delivery chain and the changes they experienced over the preceding years, but also in a context of scarce resources, of vertical and horizontal petition and health insurance reform. By targeting THs more than other health facilities in Weifang Prefecture, on which this study is focused, the NRCMS can influence the activity and the efficiency of 濟(jì)南大學(xué)畢業(yè) 論文外文資料翻譯 3 these facilities. The main channels are the likely increase in demand induced by insurance and the implementation of contracts. Therefore, identifying the determinants of THs39。 Du, 2020。Jacobs, Smith, amp。 potential additional effects on efficiency behavior in different production technologies, efficiency scores of the curative DEA model are introduced into the regression of the determinants of preventive efficiency, and viceversa. . Environmental factors The structural characteristic of the township is measured by the density of the population in the township. It can influence the demand addressed to the THs and thus the volume of medical services they delivered. The relationship of the TH with its environment is measured by two sets of variables. The density of village health stations(measured by the number of village health stations per 10,000 households) and the distance of the TH to the nearest county hospital reflect the geographical environment of THs. The density of village health stations can have two opposite effects on the efficiency of THs. A negative effect may be expected as village health stations and THs might pete for the delivery of preventive activities and basic medical consultations. A positive effect ma