ObjectiveTo analyze the allocation efficiency of health resources in the western region of China, and to explore the influence of external environmental factors on the allocation efficiency, to provide reference for optimizing the allocation of resources.MethodsIn this study, we employed a three-stage Data Envelopment Analysis (DEA) model alongside Tobit regression analysis to evaluate the efficiency of health resource allocation and explore the factors that influence it across western China. This analysis focused on data from 2021, covering ten provinces. Through this combined approach, the study aimed to uncover key insights into the determinants and variations in resource allocation efficiency within western China.ResultsFollowing the three-stage DEA analysis, the results showed that health resource allocation in western China achieved a comprehensive efficiency of 0.979, a pure technical efficiency of 0.980, and scale efficiency of 0.999. Notably, six provinces, specifically Chongqing, Guizhou, Yunnan, Tibet, Qinghai, and Ningxia, maintained efficient performance both before and after adjustment. The extensive efficiency of 3 provinces, including Sichuan, Shaanxi, and Gansu decreased. Xinjiang's comprehensive efficiency improved. The comprehensive efficiency of the southwest area was higher than that of the northwest area. The Tobit regression analysis revealed that factors such as per capita disposable income, the share of government spending in total healthcare expenditure, and the medical service price index significantly influenced the efficiency of health resource allocation in Western China.ConclusionEnvironmental factors appeared to inflate the efficiency estimates of health resource allocation in China's western region, with considerable disparities across different areas. To address these issues, the government should advance reforms in medical resource distribution, enhance management practices and technology, optimize resource allocation structures, and minimize resource wastage. At the same time, strategies should be formulated according to provincial characteristics, and interregional cooperation and resource sharing should be strengthened to achieve complementary advantages and common development.