Prinja Shankar, Manchanda Neha, Aggarwal Arun Kumar, Kaur Manmeet, Jeet Gursimer, Kumar Rajesh
School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2013 Dec;138(6):1003-11.
BACKGROUND & OBJECTIVES: Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency.
Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation.
The cost of referral transport per year varied from [symbol: see text] 5.2 million in Narnaul to [symbol: see text] 9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average [symbol: see text] 15.5 per km to [symbol: see text] 9.57 per km.
INTERPRETATION & CONCLUSIONS: Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.
印度不同邦推出了各种转诊运输服务模式，旨在降低孕产妇和婴儿死亡率。大多数关于转诊运输的研究都集中在服务的覆盖范围、质量和及时性上，而关于成本和效率的信息不多。本研究旨在分析哈里亚纳邦三个地区由公共资金资助和管理的转诊运输服务模式的成本，并评估其成本和技术效率。
收集了2010年哈里亚纳邦三个地区提供转诊运输服务所花费的所有资源数据。使用适当方法分摊邦一级产生的成本。采用数据包络分析（DEA）技术评估救护车的技术效率。为了估计救护车服务的有效运营规模，使用二次回归方程将平均成本与每个救护车站行驶的公里数进行回归分析。
每年的转诊运输成本从纳瑙尔的520万卢比到安巴拉的980万卢比不等。工资（36 - 50%）构成主要成本。发现转诊运输的平均效率水平为76.8%。发现每月搭载137名患者运营一辆救护车可将单位成本从平均每公里15.5卢比降至9.57卢比。
我们的结果表明，哈里亚纳邦由公共提供的转诊运输服务运营效率较高。增加目标人群对转诊运输服务的需求是进一步提高未充分利用的救护车效率的一个机会。
