How can China's medical manufacturing listed firms improve their technological innovation efficiency? An analysis based on a three-stage DEA model and corporate governance configurations

China's medical manufacturing industry is in a critical stage of transition to independent innovation. The government should create a business environment that is conducive to the development of the industry, and firms need to accurately identify obstacles to their innovation governance. However, the relationship between corporate governance (CG) and innovation efficiency remains unclear. Based on the CG configuration research framework, this study analyzes, using a three-stage data envelopment analysis (DEA) model and panel data fuzzy-set qualitative comparative analysis (fsQCA), the relationship between the internal governance and technological innovation efficiency (TIE) of China's medical manufacturing listed firms (CMMLFs) with the consideration of the impact of environmental parameters on innovation performance. The results show that (1) government support and medical spending among environmental factors create innovation input redundancy, and education investment and industrial competition promote innovation efficiency; and (2) the high TIE of firms is the outcome of multiple internal mechanisms, and there are five possible paths conducive to improving TIE and two mainstream, stable configurations for high technical efficiency. Our study systematically analyzes the external and internal organizational factors as two situational factors for CG and provides a reference for decision-making to further promote the efficient innovation of medical manufacturing firms.