Akazili J, Adjuik M, Chatio S, Kanyomse E, Hodgson A, Aikins M, Gyapong J
Navrongo Health Research Centre, Health Research Unit, Ghana Health Service, P.O. Box 114, Navrongo, UE/R, Ghana.
Ghana Med J. 2008 Dec;42(4):149-55.
Health systems in developing countries including Ghana are faced with critical resource constraints in pursuing the goal of improving the health status of the population. The constrained ability to adequately meet health care needs is exacerbated by inefficiency in the health care systems, especially within public health centres.
The study used Data Envelopment Analysis (DEA) method, to calculate the technical and allocative efficiency of 113 randomly sampled health centres. A logistic regression model was also applied on whether a health centre was technically efficient or not to determine the factors that significantly influence the efficiency of health centres.
The findings showed that 78% of health centres were technically inefficient and so were using resources that they did not actually need. Eight-eight percent were also allocatively inefficient. The overall efficiency, (product of the technical and allocative efficiency), was also calculated and over 90% of the health centres were inefficient. The results of a logistic regression analysis show that newer health centres and those which receive incentives were more likely to be technically efficient compared to older health centres and those who did receive incentives.
The results broadly point to grave inefficiency in the health care delivery system of the health centres and that lots of resources could be saved if measures were put in place to curb the waste. Incentives to health centres were found to be major motivating factors to the promotion of efficiency.
包括加纳在内的发展中国家的卫生系统在追求改善民众健康状况的目标时面临着严峻的资源限制。医疗保健系统效率低下,尤其是在公共卫生中心,进一步加剧了满足医疗保健需求的能力受限问题。
该研究采用数据包络分析(DEA)方法,计算了113个随机抽样卫生中心的技术效率和配置效率。还应用逻辑回归模型来分析卫生中心是否技术有效,以确定显著影响卫生中心效率的因素。
研究结果表明,78%的卫生中心技术效率低下,因此在使用它们实际上并不需要的资源。88%的卫生中心配置效率也低下。还计算了总体效率(技术效率和配置效率的乘积),超过90%的卫生中心效率低下。逻辑回归分析结果显示,与较旧的卫生中心和未获得激励措施的卫生中心相比,较新的卫生中心和获得激励措施的卫生中心更有可能技术有效。
结果大致表明卫生中心的医疗保健提供系统存在严重效率低下问题,如果采取措施遏制浪费,大量资源可以节省下来。发现对卫生中心的激励措施是提高效率的主要推动因素。