Technical efficiency of neonatal health services in primary health care facilities of Southwest Ethiopia: a two-stage data envelopment analysis

Yitbarek, Kiddus; Abraham, Gelila; Adamu, Ayinengida; Tsega, Gebeyehu; Berhane, Melkamu; Hurlburt, Sarah; Mann, Carlyn; Woldie, Mirkuzie

doi:10.1186/s13561-019-0245-7

Cited by 9 publications

(22 citation statements)

References 21 publications

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“…Similar to this study, in the study conducted by Leng et al [50], there was a positive relationship between income per capita and the efficiency score of primary healthcare, whereas there was no relationship between the education level of the society in which the service was provided and the efficiency score of the primary healthcare. Likewise, in the study of Yitbarek et al [53] on the institutions that provide primary healthcare services in Ethiopia, it was found that the education level of the society in which service was provided had no statistically effect on the efficiency score of primary healthcare.…”

Section: Discussionmentioning

confidence: 97%

Investigation of factors affecting efficiency of primary healthcare in Turkey with two-stage data envelopment analysis

İlgün

Şahin

2020

International Journal of Healthcare Management

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This study had two aims, one of which was to reflect the efficiencies of all institutions providing primary healthcare in Turkey between the years of 2012-2014 at the level of provinces. The second aim was to identify the factors that affect the efficiency scores. Two-stage data envelopment analysis method was utilized accordingly. The findings of the study showed that the number of provinces providing primary healthcare efficiently was found as 20 for 2012, 17 for 2013 and 24 for 2014. The study also showed that the efficiency scores of the provinces in primary healthcare changed according to income, apart from the input and output variables. According to the results of the study, it was found that most of the provinces are inefficient. In order to improve this, attention should be paid to decreasing inputs and infant mortality rate and increasing the average number of follow-up per infant, especially in provinces where income per capita is low. In addition, it is thought that the results of this study will provide important information to healthcare administrators and policy makers regarding primary care, which has an important role in preventing outbreaks (for example COVID-19), monitoring diseases, protecting and promoting health.

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Section: Discussionmentioning

confidence: 97%

Investigation of factors affecting efficiency of primary healthcare in Turkey with two-stage data envelopment analysis

İlgün

Şahin

2020

International Journal of Healthcare Management

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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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“…Studies indicated that sex [ 14 ], educational level [ 15 , 16 ], experience [ 15 – 17 ], a distance of the residence from the facility of the manager [ 15 , 18 ], patient waiting time [ 17 , 19 – 22 ], hospitals service years [ 15 , 16 , 19 ] and presence of clinicians’ on-job training [ 20 , 23 ] were organizational determinants of the technical efficiency. Whereas the hospital’s geographical location [ 20 , 24 , 25 ], size [ 14 , 22 , 26 , 27 ], catchment population [ 15 – 17 , 19 , 21 , 28 , 29 ], and availability of health facilities within the catchment area [ 15 , 16 , 30 ] were environmental factors associated with efficient utilization of resources in the health facilities.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the widespread application of technical efficiency [ 31 , 32 ], scarce evidence was generated on the efficient provision of neonatal health services in hospitals. Besides, most studies [ 17 , 19 , 26 , 33 ] were not specific and none of the studies was on neonatal health services in primary hospitals though it is crucial for the improvement of neonatal mortality. A study conducted by Yitbarek et al in 2019 [ 17 ] revealed that the majority of the health posts and health centres in southwest Ethiopia were providing technically inefficient neonatal health care.…”

Section: Introductionmentioning

confidence: 99%

“…Besides, most studies [ 17 , 19 , 26 , 33 ] were not specific and none of the studies was on neonatal health services in primary hospitals though it is crucial for the improvement of neonatal mortality. A study conducted by Yitbarek et al in 2019 [ 17 ] revealed that the majority of the health posts and health centres in southwest Ethiopia were providing technically inefficient neonatal health care. But the study failed to include the primary hospitals although the primary hospitals are the primary referral centre and components of the primary health care units in the health systems of Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the technical efficiency of neonatal health service among primary hospitals of northwest Ethiopia: Using two-stage data envelopment analysis and Tobit regression model

2022

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Introduction Most cases of neonatal mortality are preventable but a substantial number of cases get complicated and become irreversible not only due to scarcity but also due to inefficient utilization of available resources in the health service. However, limited evidence shows the efficiency level of health facilities in Ethiopia. Therefore, this study aimed to assess the technical efficiency of neonatal health service and its associated factors among primary hospitals in three zones of Northwest Ethiopia. Methods A facility-based cross-sectional study was conducted among fifteen randomly selected primary hospitals from March 17 to April 17, 2021. Input data on non-salary recurrent costs, salary costs, and the number of beds, and output data on neonatal admissions, outpatient visits, and referrals for the 2019/20 fiscal year were collected using a document review. In the first stage of analysis, input-oriented data envelopment analysis with a variable return-to-scale assumption was employed to estimate the efficiency scores using DEAP 2.1. A Tobit regression model was fitted in the second stage to identify the associated factors with technical efficiency. Variables with a p-value <0.05 were declared as statistically associated factors. Results In this study, 80% of the primary hospitals were pure technical efficient whereas 46.67% of the facilities were scale efficient with all of the scale inefficient hospitals operating below their scale. The mean pure technical and scale efficiency score of primary hospitals was 0.948±0.113 and 0.887±0.143, respectively. Total catchment population, incentive packages for the clinical staff, and the educational status of the manager were positively associated with the technical efficiency of hospitals. On the other hand, technical efficiency was negatively associated with the presence of a health facility that provides neonatal health services near the hospital and the distance of the manager’s residence. Conclusion Though most of the primary hospitals in Northwest Ethiopia were technical efficient, more than half of them were working below their scale of operation. Our results also indicated that introducing the performance-based provision of incentive packages for clinical staff and employing master’s and above-educated health professionals as a manager might improve the efficient utilization of resources in primary hospitals.

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Technical efficiency of neonatal health services in primary health care facilities of Southwest Ethiopia: a two-stage data envelopment analysis

Cited by 9 publications

References 21 publications

Investigation of factors affecting efficiency of primary healthcare in Turkey with two-stage data envelopment analysis

Investigation of factors affecting efficiency of primary healthcare in Turkey with two-stage data envelopment analysis

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

Evaluating the technical efficiency of neonatal health service among primary hospitals of northwest Ethiopia: Using two-stage data envelopment analysis and Tobit regression model

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