Yitbarek Kiddus, Adamu Ayinengida, Tsega Gebeyehu, Siraneh Yibeltal, Erchafo Belay, Yewhalaw Delenasaw, Tekle Firew, Woldie Mirkuzie
Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
Department of Public Health, College of Health Sciences, Wachemo University, Hossana, Ethiopia.
Health Serv Insights. 2019 Apr 10;12:1178632919837630. doi: 10.1177/1178632919837630. eCollection 2019.
As the Ethiopian health system faced critical resource constraints, wise use of the available health resources is a priority agenda. Therefore, our study aimed to assess technical efficiency of maternal and reproductive health services in public hospitals of Oromia regional state, Ethiopia. Two-stage data envelopment analysis was performed among 14 hospitals with input orientation and variable returns to scale assumptions. Technical efficiency scores were computed at the first stage, and predictors were determined using Tobit regression at the second stage. The assessment revealed that 12 (85.7%) hospitals were pure technical efficient and 9 (64.29%) hospitals were scale efficient. Level (primary/general) (β = 1.17, 95% confidence interval [CI] = 0.16-2.18), service years (β = 0.02, 95% CI = 0.003-0.03), and size of catchment population (β = 5.58E-07, 95% CI = 2.95E-08 to 1.09E-06) were positively associated with technical efficiency of maternal and reproductive health service, whereas average waiting time for maternal health service (β = -0.03, 95% CI = -0.05 to -0.01) was negatively associated with efficiency. In conclusion, most of the hospitals were technically efficient and around two-thirds were operating scale efficient. Allocation of more resources to older secondary hospitals with larger catchment population could result in more efficient use of resources for maternal and reproductive health service delivery.
由于埃塞俄比亚卫生系统面临严重的资源限制，明智地利用现有卫生资源是一项优先议程。因此，我们的研究旨在评估埃塞俄比亚奥罗米亚州公立医院孕产妇和生殖健康服务的技术效率。在14家医院中采用输入导向和规模报酬可变假设进行了两阶段数据包络分析。在第一阶段计算技术效率得分，在第二阶段使用托比特回归确定预测因素。评估显示，12家（85.7%）医院纯技术效率高，9家（64.29%）医院规模效率高。医院级别（初级/综合）（β = 1.17，95%置信区间[CI] = 0.16 - 2.18）、服务年限（β = 0.02，95%CI = 0.003 - 0.03）和集水区人口规模（β = 5.58E - 07，95%CI = 2.95E - 08至1.09E - 06）与孕产妇和生殖健康服务的技术效率呈正相关，而孕产妇保健服务的平均等待时间（β = -0.03，95%CI = -0.05至-0.01）与效率呈负相关。总之，大多数医院技术效率高，约三分之二运营规模效率高。将更多资源分配给集水区人口较多的老二级医院可能会更有效地利用资源来提供孕产妇和生殖健康服务。
