Objective To analyze the allocation efficiency of human resources for primary⁃level medical and health care in China and its influencing factors, providing countermeasure suggestions for strengthening the capacity of primary⁃level medical and health service. Methods The number of grassroots health technicians, the number of village doctors and health workers were selected as input indicators, and the person⁃time of outpatient visits, hospital admissions and family health service visits as output indicators. The per capita GDP, population density, total dependency ratio and government health expenditure were taken as environmental variables. Using the three⁃stage data envelopment analysis model, the characteristics of the efficiency of human resource allocation for primary⁃level medical and health care in 31 provinces (autonomous regions and municipalities directly under the central government) of China in 2022 were evaluated from a static perspective. The Malmquist index was used to analyze the changes in the allocation efficiency of human resources for primary⁃level medical and health care in China from 2013 to 2022 from a dynamic perspective. Results (1) In 2022, the mean comprehensive efficiency value of primary⁃level medical and health care human resource allocation in China was 0.779. Eleven provinces (autonomous regions, and municipalities directly under the central government) were technically efficient (with comprehensive efficiency value of 1), while the remaining 20 were technically inefficient, with Heilongjiang Province recording the lowest comprehensive efficiency value (0.356). After excluding the effects of external environmental factors and random disturbances, the mean comprehensive efficiency value decreased to 0.713. At this point, only eight provinces (autonomous regions, and municipalities directly under the central government) remained technically efficient, whereas the number of technically inefficient ones increased to 23, with Qinghai Province having the lowest comprehensive efficiency value (0.314). (2) Environmental variables could affect the efficiency of resource allocation. Among them, the total dependency ratio had a significant positive effect on the improvement of resource allocation efficiency (P<0.05). (3) From 2013 to 2022, the total factor productivity growth of the allocation efficiency of primary⁃level medical and health care human resources was slow, with an average value of 1.018. Conclusion The efficiency of primary⁃level medical and health care human resource allocation in China requires further improvement, with significant inter⁃provincial disparities and a notable negative influence from the total dependency ratio. It is recommended that the implementation of the Healthcare Strengthening at the Grassroots Project serve as an opportunity to systematically enhance the efficiency and service capacity of primary⁃level medical and health care human resources through measures such as optimizing the talent structure, increasing fiscal investment, and building close⁃knit medical alliances. 

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