Abstract: Objective To explore medical service efficiency of public county traditional Chinese medicine(TCM)hospitals and its influencing factors in Shandong province and to provide references for improving the efficiency of the hospitals.Methods Data envelopment analysis was used to evaluate efficiency level and Tobit regression model was used to analyze influencing factors of the efficiency.Results The technical efficiency(TE)and pure technical efficiency(PTE)value for the public county TCM hospitals increased from 0.772 and 0.773 to 0.813 and 0.910, respectively, from 2006 to 2012 and the hospitals located at developed regions presented higher TE and PTE than the hospitals at undeveloped regions, especially after 2009. No obvious improvement in scale efficiency(SE)of the hospitals was observed, however the gap in the SE among the hospitals located at regions with different economic development level narrowed.The medical service efficiency of a public county TCM hospital was inversely correlated with the number of beds, average hospitalization days, average medical expense per inpatient, asset-liability ratio, and the ratio of drug income versus total income of the hospital.Conclusion The TE of public TCM hospitals at county level showed an increasing trend between 2006 and 2012 mainly due to the increase of PTE and the trend was much more obvious for the hospitals in developed regions;controlling the scale of a TCM hospital, shortening average duration of hospitalization, and reducing hospitalization expense and asset-liability ratio could improve medical service efficiency of county public TCM hospitals.