Abstract
This study assesses the efficiency of French regional hospitals (excluding DOM-TOM and Corsica) from 2018 to 2021, distinguishing the prepandemic (2018-2019) and pandemic (2020-2021) periods using data envelope analysis (DEA). Two models were developed: one minimizing deaths as an adverse outcome, and the other incorporating both deaths and emergency admissions to capture the pressure on hospitals based on data on hospital beds, doctors, and nurses. The results reveal significant regional disparities in healthcare care efficiency. Île-de-France and Centre-Val de Loire consistently performed well, while Provence-Alpes-Côte d'Azur, Auvergne-Rhône-Alpes, and Occitanie showed persistent inefficiencies. Interestingly, Grand Est, despite being heavily impacted, demonstrated high efficiency, suggesting adaptations driven by the crisis. Some resource-rich regions performed poorly due to organizational issues such as low bed turnover and poor hospital occupancy. These findings highlight the need for targeted reforms in resource allocation, interregional coordination, and hospital infrastructure planning. Limitations include data inconsistencies between regions and the lack of differentiation between pandemic waves. Future studies could refine these insights by analyzing temporal variations with more precision.