Lari Majid Safaei, Sefiddashti Sara Emamgholipour
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2021 May;50(5):1017-1027. doi: 10.18502/ijph.v50i5.6119.
Mental disorders and problems put a heavy burden on communities. Since resources allocated to the mental health systems are finite, it seems necessary to assess the efficiency of mental health systems. In this study, we assess the efficiency of mental health care systems across 12 Middle East and North Africa (MENA) countries in 2014.
We used data envelopment analysis (DEA). The number of psychiatrists and nurses working in the mental health sector, the number of beds in mental hospitals, and the healthcare expenditures were included as inputs. The disability-adjusted life years (DALYs) of mental and substance use disorders was considered as the output. This approach is an input-oriented and a variable returns to scale.
Countries such as Egypt, Iraq, Lebanon, and Qatar with the efficiency scores of 1.00 are entirely efficient. However, Bahrain and Iran with the efficiency scores of 0.50 and 0.58 are the most inefficient countries, respectively. After measuring the efficiency model, the radial super-efficiency showed that Egypt and Lebanon with the efficiency scores of 4.73 and 4.09 were ranked as the first and second by far. Qatar and Iraq compared with the previous analysis, and with the efficiency scores of 1.72 and 1.58, were ranked as the third and fourth. Bahrain and Iran were as inefficient as the previous model.
This study depicted a general portrait of the performance of mental health systems across MENA countries. Countries performed efficiently, have taken advantage of comprehensive programs in mental health sector. Countries are strongly recommended to complement their datasets of mental health to make future studies able to evaluate mental health systems more accurately and perfectly.
精神障碍和问题给社区带来了沉重负担。由于分配给精神卫生系统的资源有限,评估精神卫生系统的效率似乎很有必要。在本研究中,我们评估了2014年中东和北非(MENA)12个国家精神卫生保健系统的效率。
我们使用了数据包络分析(DEA)。精神卫生部门工作的精神科医生和护士数量、精神病院的病床数量以及医疗保健支出被作为投入。精神和物质使用障碍的伤残调整生命年(DALYs)被视为产出。这种方法是面向投入且规模报酬可变的。
埃及、伊拉克、黎巴嫩和卡塔尔等国家效率得分均为1.00,完全有效。然而,巴林和伊朗的效率得分分别为0.50和0.58,是效率最低的国家。在测量效率模型后,径向超效率显示埃及和黎巴嫩的效率得分分别为4.73和4.09,目前分别排名第一和第二。与之前的分析相比,卡塔尔和伊拉克的效率得分分别为1.72和1.58,排名第三和第四。巴林和伊朗与之前的模型一样效率低下。
本研究描绘了中东和北非国家精神卫生系统绩效的总体情况。表现高效的国家利用了精神卫生部门的综合项目。强烈建议各国补充其精神卫生数据集,以便未来的研究能够更准确、更完善地评估精神卫生系统。