Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 8 2021 07 22 1613 1623 Shaomin Wang School of Medical Economics and Management, Anhui University of Chinese Medicine, Hefei 230012, China Qunshan Tao School of Medical Economics and Management, Anhui University of Chinese Medicine, Hefei 230012, China 2020 10 16 2021 02 10 Background: Hierarchical medical system (HMS) is a good policy to promote the fairness of medical services for residents. Given the importance of HMS, it is necessary to know the implementation effect of the policy. Therefore, we aimed to analyze the efficiency of medical service resources in China under the background of hierarchical medical policy. Methods: Based on the panel data of China's medical resources in 2015-2019, we used DEA model to calculate the technical efficiency (TE), pure technical efficiency (PTE) and scale efficiency (SE) of medical resources from both lateral and longitudinal aspects. We used Malmquist index to evaluate the change trend of efficiency, and further we compared the efficiency differences of regions and medical institutions. Results: In lateral evaluation results, TE was relatively stable, while total factor productivity (TFP) was on the rise. In longitudinal evaluation results, TE and TFP showed a downward trend. Conclusion: The government should consider the differences in development between regions and make health plans by regions. Medical institutions should strive to break down the constraints and make use of their advantages, which is conducive to improving efficiency. https://ijph.tums.ac.ir/index.php/ijph/article/view/22529 https://ijph.tums.ac.ir/index.php/ijph/article/download/22529/7319