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坦桑尼亚公立医院规模效率水平研究。

Examination on level of scale efficiency in public hospitals in Tanzania.

作者信息

Fumbwe Fatuma, Lihawa Robert, Andrew Felician, Kinyanjui George, Mkuna Eliaza

机构信息

Faculty of Social Sciences, Department of Economics, Mzumbe University, P.O Box 5, Morogoro, Tanzania.

Senior Researcher, University of Cape Town, Cape town, South Africa.

出版信息

Cost Eff Resour Alloc. 2021 Aug 11;19(1):49. doi: 10.1186/s12962-021-00305-4.

Abstract

PURPOSE

Tanzania has implemented policies that aim at improving health sector performance as well as the general health status of citizens. Establishment of community insurance fund, increase government budget allocation in health sector, establishment of institutions for critical and special diseases like Tanzania Ocean road cancer institute, Muhimbili Orthopaedic Institute and many other that aim at improving sector efficiency. These efforts and policies had a direct impact on improving the health sector and achieving Sustainable Development Goals (SDGs). Despite these improvement efforts, the health sector continues to face enormous challenges. Among the major challenges identified is the level of inefficiencies in healthcare delivery. It is for this reason; this paper examines the scale efficiency level in Tanzania's public hospitals.

METHODS

Using data from the Ministry of Health, this paper employs the Input based Data Envelopment Analysis (DEA) to examine Tanzania's public hospital efficiency levels. DEA has been applied because it can handle multiple inputs and output that can have different units simultaneously.

RESULTS

Findings showed that the average scale efficiency was 78.6%.and 72.9%for regional and district hospitals respectively. Additionally, 43.8% of the regional referral hospitals attained the most productive scale size compared to 21.05% in district hospitals.

CONCLUSION

The study concludes that there is dire need for the ministry of health to consider resource reallocation across public hospitals. Periodic re-estimation of efficiency levels coupled with increased health care input injection is of urgent need.

摘要

目的

坦桑尼亚实施了旨在提高卫生部门绩效以及公民总体健康状况的政策。建立社区保险基金,增加政府在卫生部门的预算分配,建立针对重大和特殊疾病的机构,如坦桑尼亚海洋路癌症研究所、穆希姆比利骨科研究所等许多旨在提高部门效率的机构。这些努力和政策对改善卫生部门和实现可持续发展目标产生了直接影响。尽管做出了这些改进努力,卫生部门仍然面临巨大挑战。其中确定的主要挑战之一是医疗服务提供的低效率水平。正是出于这个原因,本文考察了坦桑尼亚公立医院的规模效率水平。

方法

本文利用来自卫生部的数据,采用基于投入的数据包络分析(DEA)来考察坦桑尼亚公立医院的效率水平。之所以应用DEA,是因为它可以同时处理多个具有不同单位的投入和产出。

结果

研究结果显示,区域医院和地区医院的平均规模效率分别为78.6%和72.9%。此外,43.8%的区域转诊医院达到了最有效的规模大小,而地区医院这一比例为21.05%。

结论

该研究得出结论,卫生部迫切需要考虑在公立医院之间重新分配资源。迫切需要定期重新评估效率水平,并增加医疗投入。

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