Abstract: Objective To analyze the changes in overall,technical,and scale efficiency of county public hospitals in Shandong province under new medical reform background.Methods Using data envelopment analysis(DEA) software 2.1,we calculated overall,technical,and scale efficiency scores of 10 county public hospitals during the period from 2010 to 2013 with the new medical reform.Results Of the 10 county public hospitals during the period,4 were in the condition of constant return to scale;2 were in increasing returns to scale;only one was in decreasing returns to scale;and other 3 in the condition of variable returns to scale.Conclusion The impact of the new medical reform on the operation of medical institutions manifests gradually,and the impact upon the return to scale is different among county public hospitals in Shandong province.