Abstract: ObjectiveTo analyze dynamic changes of county public hospitals' efficiency in Shandong province during the period between 2006 and 2012.MethodsThe dynamic changes in total factor productivity(TFP)indice and its decomposition items of 227 county public hospitals in Shandong province before and after the implementation of new health care reform from 2006 through 2012 were analyzed with data envelopment analysis-Malquist index.ResultsAfter the implementation of new health care reform,82.38% of the hospitals showed improvement in TFP mainly because of the technical progress;however 59.91% of hospitals did not improve their technical efficiency;although 52.71% of the general hospitals achieved the improvement in pure technical efficiency,they failed to have the improvement in scale efficiency and 48.98% of the traditional medicine hospitals showed a decreased trend in both pure technical and scale efficiency.ConclusionThe TFP showed an increase trend in the most of the hospitals in Shandong province after the implementation of new health care reform but excessively relied on technical progress,suggesting developments in rational scale for general hospitals and medical technology for traditional Chinese medicine hospitals are warranted for further TFP improvement.