Levels, trends and determinants of technical efficiency of general hospitals in Uganda: data envelopment analysis and Tobit regression analysis

BMC Health Services Research

Pauline Bakibinga¹  Rogers Enyaku²  Paschal N. Mujasi³  Robert Anguyo⁴  Walter Odoch⁵  Joyce Abaliwano⁶  Dickson Turyareeba⁶  Tom Aliti⁷  Rogers Ayiko⁸ 

[1] African Population & Health Research Center, P.O. Box 10787-00100, Manga Close, Off Kirawa Road, Nairobi, Kenya;Community Resource Development Initiative, P. O. Box 6653, Kampala, Uganda;Department of Economics and Business, Universitat Pompeu Fabra, Barcelona School of Management, Balmes 132, 08001, Barcelona, Spain;Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK;Faculty of Health Sciences, Nile University, P.O Box 1070, Arua, Uganda;East Central and Southern Africa Health Community, P.O. Box 1009, 157 Olorien, Njiro Road ECSA-HC, Arusha, Tanzania;Makerere University Business School, Plot 21 A, Port Bell Rd, Kampala, Uganda;Ministry of Health, P.O Box 7272, Plot 6, Lourdel Road, Nakasero, Kampala, Uganda;The Foundation for African Empowerment, P. O. Box 116, Arusha, Tanzania;

关键词: Data envelopment analysis;    General hospital;    Technical efficiency;    Tobit regression analysis;    Uganda;   

DOI  :  10.1186/s12913-020-05746-w

来源: Springer

【 摘 要 】

BackgroundGeneral hospitals provide a wide range of primary and secondary healthcare services. They accounted for 38% of government funding to health facilities, 8.8% of outpatient department visits and 28% of admissions in Uganda in the financial year 2016/17. We assessed the levels, trends and determinants of technical efficiency of general hospitals in Uganda from 2012/13 to 2016/17.MethodsWe undertook input-oriented data envelopment analysis to estimate technical efficiency of 78 general hospitals using data abstracted from the Annual Health Sector Performance Reports for 2012/13, 2014/15 and 2016/17. Trends in technical efficiency was analysed using Excel while determinants of technical efficiency were analysed using Tobit Regression Model in STATA 15.1.ResultsThe average constant returns to scale, variable returns to scale and scale efficiency of general hospitals for 2016/17 were 49% (95% CI, 44–54%), 69% (95% CI, 65–74%) and 70% (95% CI, 65–75%) respectively. There was no statistically significant difference in the efficiency scores of public and private hospitals. Technical efficiency generally increased from 2012/13 to 2014/15, and dropped by 2016/17. Some hospitals were persistently efficient while others were inefficient over this period. Hospital size, geographical location, training status and average length of stay were statistically significant determinants of efficiency at 5% level of significance.ConclusionThe 69% average variable returns to scale technical efficiency indicates that the hospitals could generate the same volume of outputs using 31% (3439) less staff and 31% (3539) less beds. Benchmarking performance of the efficient hospitals would help to guide performance improvement in the inefficient ones. There is need to incorporate hospital size, geographical location, training status and average length of stay in the resource allocation formula and adopt annual hospital efficiency assessments.

【 授权许可】

CC BY