scholarly journals Data Envelopment Analysis Applications on Primary Health Care Using Exogenous Variables and Health Outcomes

2021 ◽  
Vol 13 (3) ◽  
pp. 1337
Author(s):  
Silvia González-de-Julián ◽  
Isabel Barrachina-Martínez ◽  
David Vivas-Consuelo ◽  
Álvaro Bonet-Pla ◽  
Ruth Usó-Talamantes
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Data Envelopment Analysis ◽  
Pharmaceutical Expenditure ◽  
Healthcare Services ◽  
Data Envelopment ◽  
Exogenous Variables ◽  
Healthcare Resources ◽  
Explanatory Variables ◽  
Primary Health

A data envelopment analysis was used to evaluate the efficiency of 18 primary healthcare centres in a health district of the Valencian Community, Spain. Factor analysis was used as a first step in order to identify the most explanatory variables to be incorporated in the models. Included as variable inputs were the ratios of general practitioners, nurses, and costs; as output variables, those included were consultations, emergencies, avoidable hospitalisations, and prescription efficiency; as exogenous variables, those included were the percentage of population over 65 and a multimorbidity index. Confidence intervals were calculated using bootstrapping to correct possible biases. Efficient organisations within the set were identified, although the results depend on the models used and the introduction of exogenous variables. Pharmaceutical expenditure showed the greatest slack and room for improvement in its management. Data envelopment analysis allows an evaluation of efficiency that is focussed on achieving better results and a proper distribution and use of healthcare resources, although it needs the desired goals of the healthcare managers to be clearly identified, as the perspective of the analysis influences the results, as does including variables that measure the achievements and outcomes of the healthcare services.

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 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 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.

scholarly journals Dental vulnerability scale in primary health care: evidence of content and structure internal validity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Danielle da Costa da Palacio ◽  
Flavio Rebustini ◽  
Daniele Boina de Oliveira ◽  
João Peres Neto ◽  
Wander Barbieri ◽  
...  
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Primary Health Care ◽  
Oral Health ◽  
Internal Structure ◽  
Content Validity ◽  
Internal Validity ◽  
Healthcare Services ◽  
Reliability Indicators ◽  
Primary Health

Abstract Background Access to oral health services remains a challenge in the Brazilian healthcare system, especially in the primary health care setting, where the use of a risk stratification tool that could identify individuals with higher dental vulnerability would be extremely valuable. However, there literature on this theme is scarce, and there is no validated instrument in Brazil that is capable of measuring dental vulnerability. Hence, this psychometric study aimed at the development and evaluation of content and internal structure validity of the Dental Vulnerability Scale for Primary Health Care (PHC). Methods The items were developed based on a qualitative exploratory analysis. A total of 172 items were prepared and submitted to a panel of specialists, with content validity analyzed with the Content Validity Ratio (CVR), resulting in an the initial version of the instrument composed by 41 items. Internal structure validity was analyzed by Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and by applying 3 reliability indicators (Cronbach’s Alpha, McDonald's Omega and Greatest Lower Bound – GBL), with a sample of 1227 individuals. Results The final configuration indicated a scale of 15 items divided into 4 dimensions (overall health, oral health, infrastructure, and healthcare services) with explained variance of 72.11%. The factor loads varied from 0.37 to 0.96. The model adjustment indices were set at × 2/df(51) = 3.23, NNFI = 0.95, CFI = 0.98, GFI = 0.96, AGFI = 0.97, RMSEA = 0.04 and RMSR = 0.03. Conclusion DVS presented satisfactory evidence of validity, indicating its suitability to be used by healthcare professionals, students and managers to plan oral health actions and services at PHC.

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.

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.

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