University of Greifswald, Faculty of Law and Economics, Department of Health Care Management, Friedrich-Loeffler-Str, 70, D-17489 Greifswald, Germany.
Health Econ Rev. 2011 Jul 20;1(1):5. doi: 10.1186/2191-1991-1-5.
Providing health care services in Africa is hampered by severe scarcity of personnel, medical supplies and financial funds. Consequently, managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However, very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context.
This study determines the relative efficiency of primary care facilities in Nouna, a rural health district in Burkina Faso. Furthermore, it analyses the factors influencing the efficiency of these institutions.
We apply a two-stage Data Envelopment Analysis (DEA) based on data from a comprehensive provider and household information system. In the first stage, the relative efficiency of each institution is calculated by a traditional DEA model. In the second stage, we identify the reasons for being inefficient by regression technique.
The DEA projections suggest that inefficiency is mainly a result of poor utilization of health care facilities as they were either too big or the demand was too low. Regression results showed that distance is an important factor influencing the efficiency of a health care institution
Compared to the findings of existing one-stage DEA analyses of health facilities in Africa, the share of relatively efficient units is slightly higher. The difference might be explained by a rather homogenous structure of the primary care facilities in the Burkina Faso sample. The study also indicates that improving the accessibility of primary care facilities will have a major impact on the efficiency of these institutions. Thus, health decision-makers are called to overcome the demand-side barriers in accessing health care.
在非洲提供医疗服务受到人员、医疗用品和财政资金严重短缺的阻碍。因此，医疗机构的管理者需要衡量并提高其设施的效率，以便在其现有资源的基础上提供尽可能好的服务。然而，人们对非洲医疗机构的效率知之甚少，在这方面也几乎没有应用绩效衡量工具。
本研究旨在确定布基纳法索努纳农村卫生区初级保健机构的相对效率。此外，还分析了影响这些机构效率的因素。
我们应用了一种两阶段数据包络分析（DEA）方法，该方法基于来自综合提供者和家庭信息系统的数据。在第一阶段，通过传统的 DEA 模型计算每个机构的相对效率。在第二阶段，我们通过回归技术确定效率低下的原因。
DEA 预测表明，效率低下主要是由于医疗设施的利用不佳造成的，要么是因为规模过大，要么是因为需求过低。回归结果表明，距离是影响医疗机构效率的一个重要因素。
与非洲现有医疗设施的单阶段 DEA 分析结果相比，相对有效单位的比例略高。这种差异可能是由于布基纳法索样本中初级保健设施的结构相当同质。该研究还表明，提高初级保健设施的可及性将对这些机构的效率产生重大影响。因此，卫生决策者需要克服获得卫生保健的需求方障碍。
