To explore the operational efficiency of primary care organizations in the pilot counties of close-knit county medical communities in Sichuan Province, and to provide a reference for continuing to promote the high-quality development of close-knit county medical communities across the country and help build a more synergistic and efficient county medical service network.

Primary care organizations in 37 pilot counties in Sichuan Province were used for the study, and data envelopment analysis and Malmquist index model were used for static and dynamic measurement of operational efficiency, respectively.

The mean values of comprehensive efficiency, pure technical efficiency, and scale efficiency of primary care organizations in pilot counties in Sichuan Province in 2022 were 0.806, 0.936, and 0.863, respectively. Among them, the operational efficiencies of Wenchuan (0.314), Jiuzhaigou (0.226), Seda (0.116), and Ganzi (0.061) were located below 0.400. Compared with 2018, their comprehensive efficiency and pure technical efficiency have improved, while scale efficiency was flat. The mean value of the total factor productivity index of primary care organizations in the pilot counties from 2018 to 2022 was 0.975. Further decomposing the total factor productivity index, the mean values of the technical efficiency index, the technical progress index, the pure technical efficiency index, and the scale efficiency index were 1.014, 0.962, 1.022, and 0.992, respectively.

After the implementation of the policy, the operational efficiency of primary care organizations in the pilot counties of Sichuan Province showed significant improvement, but there is still much room for improvement, and the differences between counties are more obvious. In the future, we should focus on the technical progress and scale efficiency, strengthen the continuing medical education of primary medical personnel, innovate and carry out the new technology of primary characteristics, and reasonably balance and effectively allocate the medical resources in the counties.