ObjectiveTo assess pathways for improving thoracic surgery team efficiency, providing empirical evidence for public hospital refinement. MethodsUsing 2021-2024 panel data from 9 thoracic surgery teams in Sichuan cancer hospital, we employed DEA-BCC to evaluate static efficiency (technical efficiency, scale efficiency, overall efficiency) and Malmquist index to analyze dynamic total factor productivity changes (efficiency change, technological change). Input datawere physician count and available beds. Output data were surgical rate, Grade Ⅳ surgery proportion, and inverted average length of stay. ResultsMean overall efficiency showed sustained growth, while mean scale efficiency exhibited a V-shaped trajectory. Technical efficiency increased most significantly, driving overall efficiency improvement. All teams achieved positive total factor productivity growth with technological change>1, indicating technological advancement as the primary driver. Efficiency change demonstrated divergence. Conclusion The national tertiary public hospital performance appraisal effectively guides surgical technology upgrading via specific metrics. However, persistent resource misallocation and SE divergence necessitate establishing specialized operational teams for dynamic resource monitoring and a balanced "technology-scale-management" framework to maximize sustainable resource efficiency.