This paper locates the data envelopment analysis (DEA) models with non-homogeneous decision-making units (DMUs) into more general DDF models and applies these to Hong Kong hospitals. The production process of each hospital is divided into subunits which have the same inputs and outputs and hospital performance is measured using the subunits. The paper provides CRS and VRS versions of DDF models and compares them with Cook et al. (Oper Res 61(3):666–676, 2013) and Li et al. (Health Care Manag Sci 22(2):215–228, 2019). A kernel-based method is used to estimate the distributions as well as a DEA-based efficiency analysis adapted by Simar and Zelenyuk to test the distributions. Both DDF CRS and VRS versions produce results similar to Cook et al. and Li et al. respectively. However, the statistical tests find differences for the different technologies assumed as would be expected. For hospital managers, the more generalized DDF models expand their range of options in terms of directional improvements and priorities as well as dealing with non-homogeneity.

Shuguang Lin is an Assistant Professor, Senior Engineer at Fujian Jiangxia University. He is also a fellow of the Intelligent Accounting Branch, Chinese Association of Business Accounting. He has more than 10 publications, a monograph, and an authorized invention patent. He is also an anonymous reviewer of several reputed journals.