埃塞俄比亚西南部初级卫生保健机构新生儿健康服务的技术效率：两阶段数据包络分析
Technical efficiency of neonatal health services in primary health care facilities of Southwest Ethiopia: a two-stage data envelopment analysis.
作者信息
Yitbarek Kiddus, Abraham Gelila, Adamu Ayinengida, Tsega Gebeyehu, Berhane Melkamu, Hurlburt Sarah, Mann Carlyn, Woldie Mirkuzie
机构信息
Department of Health Policy and Management, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Public health, Bahirdar University, Bahirdar, Ethiopia.
出版信息
Health Econ Rev. 2019 Oct 27;9(1):27. doi: 10.1186/s13561-019-0245-7.
BACKGROUND
Disparity in resource allocation is an issue among various health delivery units in Ethiopia. To sufficiently address this problem decision-makers require evidence on efficient allocation of resources. Therefore, the purpose of this study was to assess the technical efficiency of primary health care units providing neonatal health services in Southwest Ethiopia.
METHODS
Two-stage data envelopment analysis was conducted based on one-year (2016/17) data from 68 health posts and 23 health centers in Southwest Ethiopia. Primary data were collected from each of the facility, respective district health offices and finance and economic cooperation offices. Technical efficiency scores were calculated using data envelopment analysis software version 2.1. Tobit regression was then applied to identify determinants of technical efficiency. STATA version 14 was used in the regression model and for descriptive statistics.
RESULTS
By utilizing the best combination of inputs, eight health posts (11.76%) and eight health centers (34.78%) were found to be technically efficient in delivering neonatal health services. Compared with others included in the analysis, inefficient health delivery units were using more human and non-salary recurrent resources. The regression model indicated that there was a positive association between efficiency and the health center head's years of experience and the facility's catchment population. Waiting time at the health posts was found to negatively affect efficiency.
CONCLUSIONS
Most of health posts and the majority of health centers were found to be technically inefficient in delivering neonatal health services. This indicates issues with the performance of these facilities with regards to the utilization of inputs to produce the current outputs. The existing resources could be used to serve additional neonates in the facilities.
背景
在埃塞俄比亚，不同卫生服务机构之间资源分配不均是一个问题。为了充分解决这一问题，决策者需要有关资源有效分配的证据。因此，本研究的目的是评估埃塞俄比亚西南部提供新生儿保健服务的基层医疗卫生单位的技术效率。
方法
基于埃塞俄比亚西南部68个卫生站和23个健康中心的一年（2016/17年）数据，进行两阶段数据包络分析。从每个机构、各自的地区卫生办公室以及财政和经济合作办公室收集原始数据。使用数据包络分析软件2.1版计算技术效率得分。然后应用Tobit回归来确定技术效率的决定因素。回归模型和描述性统计分析使用STATA 14版。
结果
通过利用投入的最佳组合，发现8个卫生站（11.76%）和8个健康中心（34.78%）在提供新生儿保健服务方面技术效率较高。与分析中纳入的其他单位相比，效率低下的卫生服务机构使用了更多的人力和非工资经常性资源。回归模型表明，效率与健康中心负责人的工作年限以及机构的服务人口之间存在正相关关系。发现卫生站的候诊时间对效率有负面影响。
结论
发现大多数卫生站和大多数健康中心在提供新生儿保健服务方面技术效率低下。这表明这些机构在利用投入生产当前产出方面存在绩效问题。现有资源可用于为机构内更多的新生儿提供服务。
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