Analyses of community chronic disease management efficiency in Shanghai： a case study of hypertension and diabetes
10.19428/j.cnki.sjpm.2026.250397
- VernacularTitle:上海市社区慢性病管理效率分析：以高血压和糖尿病为例
- Author:
Kun LUO
1
;
Fei WU
2
;
Wei WANG
1
;
Qianwei ZHANG
1
;
Zhaoyu CHANG
2
;
Yuan XU
1
;
Chaowei FU
1
;
Fei YAN
1
;
Minna CHENG
2
Author Information
1. School of Public Health, Fudan University, Shanghai 200032, China
2. Institude of Chronic Non-communicable Diseases and Injury Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 201107, China
- Publication Type:Journal Article
- Keywords:
community health service institution;
chronic disease management;
health resources allocation;
efficiency evaluation;
data envelopment analysis
- From:
Shanghai Journal of Preventive Medicine
2026;38(5):355-360
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the output and efficiency of chronic disease management services for hypertension and diabetes in community health service institutions in Shanghai, to evaluate the allocation and efficiency of chronic disease management resources, and to provide references for improving the efficiency of chronic disease management in Shanghai’s communities. MethodsA total of 73 community health institutions from 15 districts of Shanghai were selected. Based on the chronic disease management resource data of community health institutions in 2019, 2021, and 2023, descriptive methods and the BCC model in Data Envelopment Analysis (DEA) were used to analyze the resource allocation, service output, and the efficiency of chronic disease management services in community health institutions in Shanghai. ResultsFrom 2019 to 2023, the indicators of resource allocation and service output of community health service institutions in Shanghai all showed upward trends. In terms of service efficiency, the average number of chronic disease patients managed by each health technician decreased from 237 to 231, and the number of patients served per 1 000 working hours decreased from 54 to 44. DEA efficiency analyses showed that the average overall efficiency increased from 0.867 in 2019 to 0.886 in 2021 and then decreased to 0.811 in 2023. The average technical efficiency decreased from 0.901 to 0.847, which was the main reason for the decline in overall efficiency. The average scale efficiency showed an initial increase followed by a decrease, rising from 0.961 in 2019 to 0.977 in 2021 and dropping back to 0.955 in 2023. The number of strong effective districts (overall efficiency=1.000) decreased from 6 in 2019 to 3 in 2023, and the efficiency differences between districts expanded. The range of overall efficiency widened from 0.622‒1.000 to 0.513‒1.000, indicating a decline in overall efficiency and an increase in inter-district heterogeneity. ConclusionFrom 2019 to 2023, the total volume of resource allocation and service output for chronic disease management in community health service institutions in Shanghai increased continuously. However, both the service output efficiency and the overall resource allocation efficiency declined, driven primarily by a decrease in technical efficiency, and accompanied by widening inter‑district disparities.
