A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Serván‐Mori, Edson; Mendoza, Miguel Ángel; Chivardi, Carlos; Pineda-Antúnez, Carlos; Rodríguez-Franco, Roxana; Nigenda, Gustavo

doi:10.1002/hpm.2785

Cited by 6 publications

(1 citation statement)

References 48 publications

(90 reference statements)

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“…On the other hand, data envelopment analysis (DEA) is commonly used to measure the efficiency of PHCIs. The selected input variables mainly include operating costs and the number of administrative and technical personnel and beds, whereas the output variables mainly include the number of outpatients, referrals, hospitalizations, family services, and preventive health services (9)(10)(11)(12). Results of these studies revealed a generally low PHCIs efficiency and large efficiency differences across regions.…”

Section: Role Of Phc In Health Systemmentioning

confidence: 99%

The Impact of Health Care Reform Since 2009 on the Efficiency of Primary Health Services: A Provincial Panel Data Study in China

Yan

Liao

et al. 2021

Front. Public Health

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Background: Primary health care (PHC) is an important part of health systems in the world and in China. To improve the efficiency of PHC institutions (PHCIs), many countries have implemented reforms, including China's health care reform since 2009. This study aims to evaluate the impact of this reform on the efficiency of PHCIs from the perspective of the whole health system.Methods: Data were collected from China Health Statistical Yearbooks and China Statistical Yearbooks published from 2005 to 2019. By taking the number of beds, health technicians and PHCIs as inputs and the proportion of diagnosis, treatment and admission in PHCIs as outputs, Malmquist DEA was used to evaluate the efficiency change of PHCIs, and panel data regression was performed to analyze the impact of the reform and other factors on such efficiency. The interaction between reform and economic level was also estimated.Results: The MPI in Beijing, Tianjin, Shanghai, Hunan, and Guangdong improved after the reform. The efficiency improvement in Beijing, Tianjin and Shanghai is mainly reflected in the growth of TC, whereas the efficiency improvement in Guangdong and Hunan is mainly reflected in the growth of EC. Meanwhile, the EC and TC in Hebei, Heilongjiang, Shandong, and other provinces deteriorated. The deterioration of MPI in Shanxi, Inner Mongolia and Jilin was mainly attributed to EC. while the deterioration of MPI in Liaoning, Anhui, and Fujian provinces is mainly attributed to TC. Since 2009, the reform exerted a negative impact on MPI (β = −0.06; P < 0.01), TC (β = −0.048; P < 0.01) and EC (β = −0.03; P < 0.01). And such negative impact was weaker in economically developed areas (β = 0.076; P < 0.01).Conclusions: Attention should be paid to future reforms: China should continue investing in PHCIs, establish a structurally integrated and functionally complementary delivery system and promote the coordination of reform policies to avoid the adverse impacts of other reform policies on PHCIs.

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Section: Role Of Phc In Health Systemmentioning

confidence: 99%

The Impact of Health Care Reform Since 2009 on the Efficiency of Primary Health Services: A Provincial Panel Data Study in China

Yan

Liao

et al. 2021

Front. Public Health

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Tackling maternal mortality by improving technical efficiency in the production of primary health services: longitudinal evidence from the Mexican case

Serván‐Mori

Chivardi

Fene

et al. 2020

Health Care Manag Sci

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Measuring and analysing social efficiency in the production of maternal health services in Mexico, 2008–15

Fene

Serván‐Mori

Mendoza

et al. 2020

Health Policy and Planning

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‘Social efficiency’ (SE) denotes the capacity of health systems to ensure equitable access to quality health services at no financial risk to users. Mexico and other low- and middle-income countries have rarely studied the performance of their health systems from an SE perspective. We propose a metric for assessing SE in the production of maternal health services in the public sector among populations without social security, analysing contextual correlates of the demand for these services. Analysis was based on administrative data collected from the 243 health jurisdictions (HJs) in Mexico for the period 2008–15. We defined production inputs as the availability of physical and human resources and social product as the unweighted sum of social sub-products, including an equitable distribution of maternal health resources, the provision of quality maternal health care and financial protection for users. We described the SE scores, the main contextual characteristics as well as those related to the demand for maternal health services. We then performed a variance decomposition analysis of the SE score by component and estimated the SE territorial concentration patterns. Finally, we identified the structural characteristics modelling SE by means of a spatial autoregressive panel data model with fixed effects by year. The SE score rose from 57.7% in 2008 to 71.9% in 2015 (P < 0.01), with its quality component accounting for the largest proportion of variance (30%). SE peaked in HJs with low social marginalization and rurality, and with service demand characterized by low parity and older populations. Different SE levels demonstrated territorial concentration patterns. Analysing SE as a metric for health system performance offers elements that contribute to the achievement of UHC as well as to the design and implementation of effective maternal health interventions intended particularly for the most socially vulnerable sectors of the population.

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A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Cited by 6 publications

References 48 publications

The Impact of Health Care Reform Since 2009 on the Efficiency of Primary Health Services: A Provincial Panel Data Study in China

The Impact of Health Care Reform Since 2009 on the Efficiency of Primary Health Services: A Provincial Panel Data Study in China

Tackling maternal mortality by improving technical efficiency in the production of primary health services: longitudinal evidence from the Mexican case

Measuring and analysing social efficiency in the production of maternal health services in Mexico, 2008–15

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