scholarly journals Factors Affecting the Technical Efficiency of Rural Primary Health Care Centers in Hamadan, Iran: Data Envelopment Analysis and Tobit Regression

2020 ◽  
Author(s):  
Saeed Mohammadpour ◽  
Javad Javan-Noughabi ◽  
Ali Vafaee Najar ◽  
Moharram Zangeneh ◽  
Shaghayegh Yousefi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Data Envelopment ◽  
Average Performance ◽  
Primary Health ◽  
Child Mortality Rate ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background Health houses are the most important providers of primary health care to the rural communities of Iran, mainly based on Behvarz workers. The aim of present study was estimate the technical efficiency of Health houses and ascertain factors that affect this efficiency. Methods This is a Longitudinal study of rural primary health care centers in Hamadan province (2002–2016). Data Envelopment Analysis was employed to estimate technical efficiency of sampled health facilities while Panel Tobit Analysis was applied to predict factors associated with efficiency levels. The outputs were child mortality rate under one year of age and child mortality rate under five years of age. The input was Behvarzes (rural health workers). Results The results of efficiency analysis showed that the average efficiency scores of the centers had a fluctuating trend during the period of the study, but the average performance scores generally decreased in 2016, as compared with 2002. The highest and lowest average performance scores were observed in 2003 (0.78) and 2013 (0.56), respectively. Number of physicians and rural primary healthcare centers per population had a positive statistically significant and the number of midwives and the total fertility per population had a negative statistically significant effect on efficiency. Conclusions The findings suggest some level of wastage of health resources in primary health centers. The policy maker and relevant stakeholders should undertake more effective need analysis, optimizing human resource utilization and reducing fertility in rural areas to promote efficiency.

scholarly journals Factors affecting the technical efficiency of rural primary health care centers in Hamadan, Iran: data envelopment analysis and Tobit regression

2020 ◽  
Author(s):  
Saeed Mohammadpour ◽  
Javad Javan-Noughabi ◽  
Ali Vafaee Najar ◽  
Moharram Zangeneh ◽  
Shaghayegh Yousefi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Data Envelopment ◽  
Average Performance ◽  
Primary Health ◽  
Child Mortality Rate ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background: Health houses are the most important providers of primary health care to the rural communities of Iran, mainly based on Behvarz workers. The aim of present study was estimate the technical efficiency of Health houses and ascertain factors that affect this efficiency.Methods: This is a Longitudinal study of rural primary health care centers in Hamadan province (2002-2016). Data Envelopment Analysis was employed to estimate technical efficiency of sampled health facilities while Panel Tobit Analysis was applied to predict factors associated with efficiency levels. The outputs were child mortality rate under one year of age and child mortality rate under five years of age. The input was Behvarzes (rural health workers). Results: The results of efficiency analysis showed that the average efficiency scores of the centers had a fluctuating trend during the period of the study, but the average performance scores generally decreased in 2016, as compared with 2002. The highest and lowest average performance scores were observed in 2003 (0.78) and 2013 (0.56), respectively. Number of physicians and rural primary healthcare centers per population had a positive statistically significant and the number of midwives and the total fertility per population had a negative statistically significant effect on efficiency. Conclusions: The findings suggest some level of wastage of health resources in primary health centers. The policy maker and relevant stakeholders should undertake more effective need analysis, optimizing human resource utilization and reducing fertility in rural areas to promote efficiency.

scholarly journals Factors affecting the technical efficiency of rural primary health care centers in Hamadan, Iran: data envelopment analysis and Tobit regression

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Saeed Mohammadpour ◽  
Javad Javan-Noughabi ◽  
Ali Vafaee Najar ◽  
Moharram Zangeneh ◽  
Shaghayegh Yousefi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Mortality Rate ◽  
Health Centers ◽  
Data Envelopment ◽  
Primary Health ◽  
Child Mortality Rate ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background Studying and monitoring the efficiency of primary health care centers has a special place in the health system. Although studies have been conducted in the field of efficiency in Iran, few have focused on rural primary health care centers. In addition, previous studies have not used the child mortality rate and Behvarzes as input and output. Objective The present study was conducted aimed to estimate the technical efficiency of rural primary health care centers and determinant factors in Hamadan using data envelopment analysis and Tobit regression. Methods This is a Longitudinal study of rural primary health care centers in Hamadan province (2002–2016). Data Envelopment Analysis was employed to estimate technical efficiency of sampled health facilities while Panel Tobit Analysis was applied to predict factors associated with efficiency levels. The outputs were child mortality rate under 1 year of age and child mortality rate 1 year to 5 years of age. The input was Behvarzes (rural health workers). Results The results of efficiency analysis showed that the average efficiency scores of the centers had a fluctuating trend during the period of the study, but the average performance scores generally decreased in 2016, as compared with 2002. The highest and lowest average performance scores were observed in 2003 (0.78) and 2013 (0.56), respectively. Number of physicians and rural primary healthcare centers per population had a positive statistically significant and the number of midwives and the total fertility per population had a negative statistically significant effect on efficiency. Conclusions The findings suggest some level of wastage of health resources in primary health centers. Findings indicate a level of waste of health resources in primary health centers. Behvarz functions in providing primary care services can be considered in the reallocation and optimal use of available resources at the level of rural health centers.

scholarly journals Factors affecting the technical efficiency of rural primary health care centers in Hamadan, Iran: data envelopment analysis and Tobit regression

2020 ◽  
Author(s):  
Saeed Mohammadpour ◽  
Javad Javan-Noughabi ◽  
Ali Vafaee Najar ◽  
Moharram Zangeneh ◽  
Shaghayegh Yousefi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Mortality Rate ◽  
Health Centers ◽  
Data Envelopment ◽  
Primary Health ◽  
Child Mortality Rate ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background: Studying and monitoring the efficiency of primary health care centers has a special place in the health system. Although studies have been conducted in the field of efficiency in Iran, few have focused on rural primary health care centers. In addition, previous studies have not used the child mortality rate and Behvarzes as input and output. Objective: The present study was conducted aimed to estimate the technical efficiency of rural primary health care centers and determinant factors in Hamadan using data envelopment analysis and Tobit regression.Methods: This is a Longitudinal study of rural primary health care centers in Hamadan province (2002-2016). Data Envelopment Analysis was employed to estimate technical efficiency of sampled health facilities while Panel Tobit Analysis was applied to predict factors associated with efficiency levels. The outputs were child mortality rate under one year of age and child mortality rate one year to five years of age. The input was Behvarzes (rural health workers).Results: The results of efficiency analysis showed that the average efficiency scores of the centers had a fluctuating trend during the period of the study, but the average performance scores generally decreased in 2016, as compared with 2002. The highest and lowest average performance scores were observed in 2003 (0.78) and 2013 (0.56), respectively. Number of physicians and rural primary healthcare centers per population had a positive statistically significant and the number of midwives and the total fertility per population had a negative statistically significant effect on efficiency.Conclusions: The findings suggest some level of wastage of health resources in primary health centers. Findings indicate a level of waste of health resources in primary health centers. Behvarz functions in providing primary care services can be considered in the reallocation and optimal use of available resources at the level of rural health centers.

Data Envelopment Analysis and Malmquist Index Application: Efficiency of Primary Health Care in Morocco and Covid-19

2021 ◽  
Vol 12 (5) ◽  
pp. 971-983
Author(s):  
Youssef Er Rays, Et. al.
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Malmquist Index ◽  
Policy Implications ◽  
Data Envelopment ◽  
Primary Health ◽  
Parametric Data ◽  
Strategic Role

The Primary Health Care in Morocco plays a very strategic role in the prevention against various diseases, in particular the current pandemic COVID 19. The efficiency of these centers has a direct impact on the reduction of this pandemic. First, this is why will try to research the literature review about the technical efficiency of primary health care. In the second step, the non-parametric: Data Envelopment Analysis method will be used to apply the empiric phase during the period 2012-2015, to estimate the relative technical efficiency, this method will be calculated by using two models: the theory of the return to scale constant with a middle equal to 0.437 and the theory of the variable return to scale with an average of 0.537. It’s necessary to combine the DEA approach with the Malmquist index to evaluate the factors of production. Finally, to compare the results of the proposed method which are generally very poor, and discuss his policy implications for health care.

scholarly journals Total Productivity Change of Health Centers in Greece in 2016-2018: A Malmquist Index Data Envelopment Analysis Application for the Primary Health System of Greece.

2021 ◽  
Author(s):  
Anastasios Trakakis ◽  
Miltiadis Nektarios ◽  
Styliani Tziaferi ◽  
Panagiotis Prezerakos
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Malmquist Index ◽  
Health Centers ◽  
Productivity Change ◽  
Data Envelopment ◽  
Primary Health ◽  
Total Productivity

Abstract Background: This paper attempts to evaluate Primary Health Care System by evaluating Health Centers in Greece.Methods: Malmquist Index Data Envelopment Analysis is applied to study the total productivity of 155 Heath Centers in Greece during 2016-2018. The Data were collected from the Ministry of Health and were submitted into quality tests to ensure validity and avoid bias.Results: This paper measures the productivity of each of the 155 Health Centers in Greece and how it shifted during 2016-2018. In addition, the overall productivity change of the 155 Health Centers over time is calculated and analyzed into a change due to technical efficiency and a change due to technological efficiency. The analysis of the means values showed a decrease of 0,9% in the overall productivity factor from the year 2016 to the year 2017 and a decrease of 5,2% from the year 2017 to the year 2018. The overall decrease in the productivity of the 155 health Centers was 3,1%. From 2016 to 2018, 59 Health centers changed their productivity mainly due to technological change, 91 mainly due to technical efficiency change, while one Health Center showed regression to its total productivity due to equal regression of its technical efficiency and technology.Conclusions: The method used is non-parametric Data Envelopment Analysis along with Malmquist Index, so as to include panel data in the analysis. Meaningful results were extracted by indicating the number of Health Centers that their productivity improved, regressed or remained constant through the period 2016-2018. This paper may contribute to improve Health Centers’ efficiency and productivity. Furthermore, valuable results can be extracted, for the National Health Care System in order to match available resources depending on each Health Center’s needs, as well as for manager planners and stakeholders in Primary Health Care.JEL Classification: C14, C32, C52, I10

scholarly journals Total productivity change of Health Centers in Greece in 2016–2018: a Malmquist index data envelopment analysis application for the primary health system of Greece

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Anastasios Trakakis ◽  
Miltiadis Nektarios ◽  
Styliani Tziaferi ◽  
Panagiotis Prezerakos
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Malmquist Index ◽  
Productivity Change ◽  
Data Envelopment ◽  
Primary Health ◽  
Health Centres ◽  
Total Productivity

Abstract Background This paper attempts to evaluate the primary health care system by evaluating health centres in Greece. Methods Malmquist Index Data Envelopment Analysis is applied to study the total productivity of 155 health centres in Greece during 2016–2018. The data were collected from the Ministry of Health and submitted to quality tests to ensure validity and avoid bias. Results This paper measures the productivity of each of the 155 health centres in Greece and how it shifted during 2016–2018. In addition, the overall productivity change of the 155 health centres over time is calculated and analysed as being due to technical efficiency or technological efficiency. The analysis of the mean values showed a decrease of 0.9% in the overall productivity factor from 2016 to 2017 and a decrease of 5.2% from 2017 to 2018. The overall decrease in the productivity of the 155 health centres was 3.1%. From 2016 to 2018, 59 health centres changed their productivity mainly due to technological change and 91 changed mainly due to technical efficiency change. One health centre showed regression to its total productivity due to equal regression of its technical efficiency and technology. Conclusions The method used is nonparametric data envelopment analysis along with the Malmquist index to include panel data in the analysis. Meaningful results were extracted by indicating the number of health centres that improved their productivity, regressed in productivity, or remained constant through the period 2016–2018. This paper may contribute to improving health centres’ efficiency and productivity. Furthermore, valuable results can be extracted for the National Health Care System to match available resources that correspond to each health centre’s needs, as well as for manager planners and stakeholders in primary health care.

Antibiotics Prescription Patterns in Primary Health Care in Qatar – A Population based study from 2017 to 2018

2020 ◽  
Author(s):  
Hanan Khudadad ◽  
Lukman Thalib
Keyword(s):  
Health Care ◽  
Antibiotic Resistance ◽  
Primary Health Care ◽  
Respiratory System ◽  
Population Based ◽  
Antibiotics Resistance ◽  
Prescription Patterns ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Background: Antibiotics are antimicrobial drugs used in the treatment and prevention of bacterial infections. They played a pivotal role in achieving major advances in medicine and surgery (1). Yet, due to increased and inappropriate use of antibiotics, antibiotic resistance (AR) has become a growing public health problem. Information on antibiotic prescription patterns are vital in developing a constructive approach to deal with growing antibiotic resistance (2). The study aims to describe the population based antibiotic prescriptions among patients attending primary care centers in Qatar. Methodology: A population based observational study of all medications prescribed in the all Primary Health Care Centers during the period of 2017-2018 in Qatar. Records with all medication prescriptions were extracted and linked to medical diagnosis. Antibiotics prescriptions records were compared to non- antibiotics records using logistic regression model in identifying the potential predictors for antibiotic prescriptions. Results: A total of 11,069,439 medication prescriptions given over a period of two-years, we found about 12.1% (n= 726,667) antibiotics prescriptions were antibiotics, and 65% of antibiotics are prescribed and received by the patients at the first visits. Paracetamol (22.3%) was the first highest medication prescribed followed by antibiotics (12.1 %) and vitamin D2 (10.2 %). More than half of all antibiotics prescribed during the period of January 2017 to December 2018 were Penicillin (56.9%). We found that half of the antibiotics (49.3 %) have been prescribed for the respiratory system comparing to the other body system. We found that males were 29% more likely be given an antibiotic compared to females (OR=1.29, 95% CI= 1.24- 1.33). Implications: The study provides a baseline data to enable PHCC management to design effective intervention program to address the problem of antibiotics resistance. Furthermore, it will help the policymakers to comprehend the size of the issue and develop a system to manage the antibiotics therapy. Conclusion: Antibiotics was the second highest medication prescribed in the Primary Health Care Centers in Qatar after paracetamol and most of the patients received it at the first visit. Most of the prescriptions in Primary Health Care Centers in Qatar were for the respiratory system, and Penicillin was the highest class prescribed. Male visitors were prescribed antibiotics more than female visitors.

scholarly journals Herbal medicine use and its associated factors in the region of Sousse (Tunisia)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Limam ◽  
J Sahli ◽  
I Khalfallah ◽  
M Mellouli ◽  
M Ghardallou ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Herbal Medicine ◽  
Medicinal Plants ◽  
Associated Factors ◽  
Medicine Use ◽  
Toxic Dose ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background Patients use medicinal plants as the first-line treatment for many chronic and acute medical conditions. The lack of access to conventional health care, historical, cultural and economic considerations contributes to the important use of these plants. The purpose was to identify medicinal plants used by primary Health Care Centers' visitors in the region of Sousse (Tunisia) and to assess its associated factors. Methods A cross-sectional descriptive study was conducted among Primary health care centers' visitors of the region of Sousse (Tunisia) in 2018. We randomly selected 18 primary health centers and 50 participants were chosen from each center. Data were collected using a pre-tested questionnaire, filled through a direct interview with participants which explores: socio-demographic variables and medicinal plants' use (name of plants, symptoms, methods of preparation, routes of administration, plant source, tolerance and side effects). Results 900 persons were included with a female predominance (72.4%). The median age of participants was 48 years ranging from 18 to 93. 65.2% (n = 587) of them report using medicinal plants to heal. The most common sources of information were family (90.5%), beliefs and traditions (56.4%). Fifty-three (53) plants were used to treat different disorders. The most used plants are: verbena (81.6%), rosemary (53.3%), mint (52%) and thyme (45.1%). The most reported treated symptoms were: flu and gastro-intestinal disorders. Plants utilization was associated to: lower age, female gender, marital status, high level of education and social existence of protection coverage. Conclusions Plants use should be based on well-conducted scientific results specifying the mechanism of action of plants, the therapeutic and toxic dose through researches on local plants samples and extracts. Key messages It seems essential to train health professionals on herbal therapy during their studies and practice. The further step after this picture of the herbal medicine use in the Region of Sousse, is to evaluate the safety and the efficacy of their use.

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