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The novelty of this paper is to introduce the mortality as an undesirable output into the derivation of the public hospital efficiency measure. Similar to the production of economic goods and pollution where the latter increase along with the former, our description of mortality in hospital is considered as weakly disposable. Based on an extension model of Kuosmanen [<jats:italic>Am. J. Agric. Econ<\/jats:italic>. <jats:bold>87<\/jats:bold> (2005) 1077\u20131082], we evaluate the public hospital efficiency with and without incorporating mortality under four scenarios. We apply this model to measure public hospital efficiency in Chinese provinces. The results indicate that no matter whether one considers undesirable outputs within the objective functions, it has a significant impact on benchmarking once the mortality is included to define the production technology.<\/jats:p>","DOI":"10.1051\/ro\/2023164","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T08:09:30Z","timestamp":1696925370000},"page":"971-987","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation and optimization of hospital system in Chinese provinces: does mortality matter?"],"prefix":"10.1051","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5126-6461","authenticated-orcid":false,"given":"Zhiyang","family":"Shen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3358-4332","authenticated-orcid":false,"given":"Kristiaan","family":"Kerstens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-297X","authenticated-orcid":false,"given":"Vivian","family":"Valdmanis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0654-0975","authenticated-orcid":false,"given":"Songkai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"250","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Ancev T., Azad M. and Akter M., Environmentally adjusted productivity and efficiency: a review of concepts, methods and empirical work, in New Directions in Productivity Measurement and Efficiency Analysis: Counting the Environment and Natural Resources, edited by Ancev T., Azad M. and Hern\u00e1ndez-Sancho F.. 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