scholarly journals Level and determinants of county health system technical efficiency in Kenya: two stage data envelopment analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Edwine Barasa ◽  
Anita Musiega ◽  
Kara Hanson ◽  
Lizah Nyawira ◽  
Andrew Mulwa ◽  
...  
Keyword(s):  
Data Envelopment Analysis ◽  
Health System ◽  
Technical Efficiency ◽  
Health Systems ◽  
Health Expenditure ◽  
Outcome Variable ◽  
Data Envelopment ◽  
Two Stage ◽  
Technical Inefficiency ◽  
Healthcare Facilities

Abstract Background Improving health system efficiency is a key strategy to increase health system performance and accelerate progress towards Universal Health Coverage. In 2013, Kenya transitioned into a devolved system of government granting county governments autonomy over budgets and priorities. We assessed the level and determinants of technical efficiency of the 47 county health systems in Kenya. Methods We carried out a two-stage data envelopment analysis (DEA) using Simar and Wilson’s double bootstrap method using data from all the 47 counties in Kenya. In the first stage, we derived the bootstrapped DEA scores using an output orientation. We used three input variables (Public county health expenditure, Private county health expenditure, number of healthcare facilities), and one outcome variable (Disability Adjusted Life Years) using 2018 data. In the second stage, the bias corrected technical inefficiency scores were regressed against 14 exogenous factors using a bootstrapped truncated regression. Results The mean bias-corrected technical efficiency score of the 47 counties was 69.72% (95% CI 66.41–73.01%), indicating that on average, county health systems could increase their outputs by 30.28% at the same level of inputs. County technical efficiency scores ranged from 42.69% (95% CI 38.11–45.26%) to 91.99% (95% CI 83.78–98.95%). Higher HIV prevalence was associated with greater technical inefficiency of county health systems, while higher population density, county absorption of development budgets, and quality of care provided by healthcare facilities were associated with lower county health system inefficiency. Conclusions The findings from this analysis highlight the need for county health departments to consider ways to improve the efficiency of county health systems. Approaches could include prioritizing resources to interventions that will reduce high chronic disease burden, filling structural quality gaps, implementing interventions to improve process quality, identifying the challenges to absorption rates and reforming public finance management systems to enhance their efficiency.

scholarly journals Measuring the efficiency of health systems in Asia: a data envelopment analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e022155 ◽  
Author(s):  
Sayem Ahmed ◽  
Md Zahid Hasan ◽  
Mary MacLennan ◽  
Farzana Dorin ◽  
Mohammad Wahid Ahmed ◽  
...  
Keyword(s):  
Data Envelopment Analysis ◽  
Health System ◽  
Technical Efficiency ◽  
Health Systems ◽  
Income Group ◽  
Data Envelopment ◽  
System Efficiency ◽  
Asian Countries ◽  
Middle Income ◽  
Health System Efficiency

ObjectiveThis study aims to estimate the technical efficiency of health systems in Asia.SettingsThe study was conducted in Asian countries.MethodsWe applied an output-oriented data envelopment analysis (DEA) approach to estimate the technical efficiency of the health systems in Asian countries. The DEA model used per-capita health expenditure (all healthcare resources as a proxy) as input variable and cross-country comparable health outcome indicators (eg, healthy life expectancy at birth and infant mortality per 1000 live births) as output variables. Censored Tobit regression and smoothed bootstrap models were used to observe the associated factors with the efficiency scores. A sensitivity analysis was performed to assess the consistency of these efficiency scores.ResultsThe main findings of this paper demonstrate that about 91.3% (42 of 46 countries) of the studied Asian countries were inefficient with respect to using healthcare system resources. Most of the efficient countries belonged to the high-income group (Cyprus, Japan, and Singapore) and only one country belonged to the lower middle-income group (Bangladesh). Through improving health system efficiency, the studied high-income, upper middle-income, low-income and lower middle-income countries can improve health system outcomes by 6.6%, 8.6% and 8.7%, respectively, using the existing level of resources. Population density, bed density, and primary education completion rate significantly influenced the efficiency score.ConclusionThe results of this analysis showed inefficiency of the health systems in most of the Asian countries and imply that many countries may improve their health system efficiency using the current level of resources. The identified inefficient countries could pay attention to benchmarking their health systems within their income group or other within similar types of health systems.

scholarly journals Technical efficiency of public health centers in three districts in Ethiopia: two-stage data envelopment analysis

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Firew Tekle Bobo ◽  
Mirkuzie Woldie ◽  
Muluemebet Abera Wordofa ◽  
Gebeyehu Tsega ◽  
Tesfamichael Alaro Agago ◽  
...  
Keyword(s):  
Public Health ◽  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Health Centers ◽  
Data Envelopment ◽  
Two Stage

scholarly journals Measuring Technical Efficiency of Health Centers in Greece: A Data Envelopment Analysis Application for the Primary Health System of Greece

2021 ◽  
Vol XXIV (Special Issue 1) ◽  
pp. 1333-1353
Author(s):  
Trakakis Anastasios ◽  
Nektarios Miltiadis ◽  
Tziaferi Styliani ◽  
Prezerakos Panagiotis
Keyword(s):  
Data Envelopment Analysis ◽  
Health System ◽  
Technical Efficiency ◽  
Health Centers ◽  
Data Envelopment ◽  
Primary Health ◽  
Analysis Application ◽  
Of Greece

scholarly journals The Efficiency Performance of Global Islamic Banks

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Norlina Kadri ◽  
Rossazana Abdul Rahim ◽  
Dyg Siti Zahrah Abg. Abdillah
Keyword(s):  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Banking Sector ◽  
Scale Efficiency ◽  
Islamic Banking ◽  
Data Envelopment ◽  
Islamic Banks ◽  
Technical Inefficiency ◽  
Efficiency Performance ◽  
Dea Approach

This paper examines the efficiency performance of the Islamic banks that consist of 14 countries namely Bahrain, Bangladesh, Iran, Jordan, Kuwait, Lebanon, Malaysia, Pakistan, Qatar, Saudi, Tunisia, Turkey, UAE, and Yemen during the period of 2004-2011 with 44 Islamic banks involved. The efficiency estimates of individual banks are evaluated using the Data Envelopment Analysis (DEA) approach. The empirical findings suggest that during the period of study, pure technical efficiency outweighs scale efficiency in the global Islamic banking sector implying that the Islamic banks have been managerially efficient in exploiting their resources to the fullest extent. The empirical findings seem to suggest that the global Islamic banks have exhibited high pure technical efficiency. During the period of study it is found that pure technical efficiency has greater influence in determining the total technical inefficiency of the Global Islamic banking sectors.

scholarly journals La salud en territorio: una aproximación a la Eficiencia Técnica del Sistema de Salud en el Ecuador mediante el Análisis Envolvente de Datos DEA

UDA AKADEM ◽  
2021 ◽  
pp. 130-157
Author(s):  
Luis Heriberto Suin-Guaraca ◽  
Edwin Paúl Feijoo-Criollo ◽  
Fabián Alejandro Suin-Guaraca
Keyword(s):  
Data Envelopment Analysis ◽  
Health System ◽  
Technical Efficiency ◽  
Universal Coverage ◽  
Data Envelopment ◽  
Non Profit ◽  
For Profit ◽  
Use Of Resources ◽  
Palabras Clave ◽  
El Sistema

La presente investigación analizó la utilización de recursos en el sistema de salud ecuatoriano, cuya escasez exige que su provisión se realice de manera que, además de garantizar su eficacia terapéutica, aseguren su uso eficiente, permitiendo alcanzar la ansiada cobertura universal. El objetivo fue conocer y examinar la Eficiencia Técnica en el sistema de salud del Ecuador durante el año 2018, aplicando el Análisis Envolvente de Datos; para ello, se consideró como DMU a los sectores de salud público y privado y a las 24 provincias del país; como inputs al personal médico y administrativo, las camas disponibles y los ambientes; como outputs a los egresos, consultas, intervenciones quirúrgicas y atención de urgencias. Los datos utilizados fueron de las encuestas RAS y ECEH del INEC para el 2018, encontrándose que el nivel de Eficiencia Técnicas en las dependencias del Ministerio de Defensa es el 84%, en las instituciones con fines de lucro el 65%, en las sin fines de lucro el 75%; a nivel provincial, Loja alcanza el 85% y Cotopaxi el 94%; por lo que la reducción necesaria de inputs, para este caso camas, de acuerdo a su output, debería ser del 35% para las instituciones con fines de lucro, del 25% para aquellas sin fines de lucro, y del 16% en el Ministerio de Defensa. En lo que respecta a las provincias, Loja y Cotopaxi, deberían reducir el personal médico y administrativo, las camas disponibles y los ambientes en el 15% y 6% respectivamente. Palabras clave: Análisis Envolvente de Datos, asignación de recursos, cobertura universal, eficiencia técnica, escasez, sistemas de salud. Palabras clave: Análisis Envolvente de Datos, asignación de recursos, cobertura universal, eficiencia técnica, escasez, sistemas de salud. Abstract This article analyzes the use of resources in the Ecuadorian health system, the scarcity of which requires their provision to be carried out in such a way that, in addition to guaranteeing their therapeutic efficacy, they ensure their efficient use, allowing the desired universal coverage to be achieved; The objective is to know and examine the Technical Efficiency in the Ecuadorian health system during the year 2018, applying the Data Envelopment Analysis, for this the public and private health sectors and the 24 provinces of the country were considered as DMU; as inputs to medical and administrative personnel, available beds and environments; as outputs to discharges, consultations, surgical interventions and emergency care. The data used were from the RAS and EHEC surveys of the INEC for 2018, finding that the level of Technical Efficiency in the departments of the Ministry of Defense is 84%, in for-profit institutions 65%, in non-profit institutions 75% profit, 85% in Loja and 94% in Cotopaxi; Therefore, the necessary reduction of beds, according to their production, should be 35% for profit-making institutions and 25% for non-profit institutions, while the Ministry of Defense 16%; at the provincial level, Loja and Cotopaxi should reduce medical and administrative staff, available beds and rooms by 15% and 6% respectively.Key words: Data Envelopment Analysis, resource allocation, universal coverage, technical efficiency, scarcity, health systems.  

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