Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Universitas Gadjah Mada, Yogyakarta, Indonesia.
Appl Health Econ Health Policy. 2018 Aug;16(4):465-480. doi: 10.1007/s40258-018-0385-7.
Limited healthcare resources in low- and middle-income countries (LMICs) have led policy-makers to improve healthcare efficiency. Therefore, it is essential to understand how efficiency has been measured in the LMIC setting.
This paper reviews methodologies used for efficiency studies in health facilities in LMICs.
We searched MEDLINE, Embase, Global Health, EconLit and ProQuest Dissertations and Theses databases to Week 6 in 2018. We included all types of quantitative analysis studies relating to the measurement of the efficiency of services at health facilities in LMICs. We extracted data from eligible studies, and assessed the validity for each study. Because of the substantial heterogeneity of the studies, results were presented narratively.
A total of 137 papers were eligible for inclusion. These articles covered a wide range of health facility types, with more than half of the studies relating to hospitals. Our systematic review showed that there is an increasing trend in efficiency measurements in LMICs using various methods. Most studies employed data envelopment analysis as an efficiency measurement method. The studies typically included physical inputs and health services as outputs. Sixty-one percent of the studies analysed the contextual variables of the health facility efficiency.
This review highlights the potential for methodological improvement and policy impacts in efficiency measurements.
中低收入国家（LMICs）的医疗保健资源有限，这促使政策制定者提高医疗保健效率。因此，了解在 LMIC 环境中如何衡量效率至关重要。
本文综述了在 LMIC 中的卫生机构中进行效率研究的方法学。
我们检索了 MEDLINE、Embase、Global Health、EconLit 和 ProQuest Dissertations and Theses 数据库，检索时间截至 2018 年第 6 周。我们纳入了所有与 LMIC 中卫生机构服务效率测量相关的定量分析研究。我们从合格的研究中提取数据，并评估了每项研究的有效性。由于研究之间存在很大的异质性，因此结果以叙述性方式呈现。
共有 137 篇论文符合纳入标准。这些文章涵盖了广泛的卫生机构类型，其中超过一半的研究与医院有关。我们的系统评价表明，使用各种方法在 LMIC 中进行效率测量的趋势正在增加。大多数研究采用数据包络分析作为效率测量方法。这些研究通常将物理投入和卫生服务作为产出。61%的研究分析了卫生机构效率的背景变量。
本综述强调了在效率测量方面方法学改进和政策影响的潜力。
