Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Victoria, Australia.
BMC Health Serv Res. 2024 Mar 21;24(1):361. doi: 10.1186/s12913-024-10843-1.
Besides the scarcity of resources, inefficient utilization of available health service resources has been the bottleneck to deliver quality health services in Ethiopia. However, Information regarding the efficiency of health service providers is limited in the country. Health service managers and policy makers must be well informed about the efficiency of health service providers and ways of using limited resources efficiently to make evidence-based decisions. This study aimed to assess the level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia.
A facility-based cross-sectional study was conducted among 27 randomly selected health centers in East Gojjam zone, Northwest Ethiopia, from October 30, 2022, to April 30, 2023. Using an interviewer-administered questionnaire and document review checklist, health centers' data was collected and entered to Epi-Data version 4.6. The data was exported to Microsoft office excel and Stata version 14 for analysis. A two-stage output-oriented data envelopment analysis with a variable return to scale assumption was employed to determine the level of technical efficiencies. Finally, the tobit regression model was applied to identify the associated factors at 5% level of significance.
In this study, 59.3% of the health centers were technically efficient. The mean technical efficiency score of the health centers was 0.899 ± 0.156. Inefficient health centers could provide more 22, 433 outpatient visits, 1,351 family planning visits, 155 referral services, 206 skilled deliveries and 385 fully vaccinations of children if they were technically efficient as their peer health centers for the same year. From the tobit regression, the catchment population and number of administrative staffs were statistically significant determinants of the technical efficiency of health centers.
The mean technical efficiency of the health centers in East Gojjam zone, Northwest Ethiopia was high. However, nearly half of the health centers were technically inefficient, which indicates the exitance of a space for further improvements in the productivity of these health centers. Employing excess number administrative staffs (above the optimal level) should be discouraged and selecting appropriate sites where the health centers to be constructed (to have large catchment population coverage) could improve the productivity of health centers.
除了资源稀缺之外，现有卫生服务资源利用效率低下也是埃塞俄比亚提供优质卫生服务的瓶颈。然而，该国关于卫生服务提供者效率的信息有限。卫生服务管理者和决策者必须充分了解卫生服务提供者的效率以及有效利用有限资源的方法，以便做出基于证据的决策。本研究旨在评估东戈贾姆地区卫生中心的技术效率水平及其相关因素。
这是一项在 2022 年 10 月 30 日至 2023 年 4 月 30 日期间在埃塞俄比亚西北东戈贾姆地区随机选择的 27 家卫生中心进行的基于设施的横断面研究。使用访谈者管理的问卷和文件审查清单收集卫生中心的数据，并输入 Epi-Data 版本 4.6。数据导出到 Microsoft Office Excel 和 Stata 版本 14 进行分析。采用具有可变回报规模假设的两阶段面向产出的数据包络分析来确定技术效率水平。最后，在 5%的显著性水平下，采用 Tobit 回归模型来确定相关因素。
在这项研究中，59.3%的卫生中心技术上是有效的。卫生中心的平均技术效率得分为 0.899±0.156。如果同年内这些卫生中心能够像他们的同行卫生中心一样技术上有效，那么它们可以提供更多的 22000 次门诊就诊、1351 次计划生育就诊、155 次转诊服务、206 次熟练分娩和 385 次儿童完全疫苗接种。从 Tobit 回归中可以看出，集水区人口和行政人员数量是卫生中心技术效率的统计学显著决定因素。
埃塞俄比亚西北东戈贾姆地区卫生中心的平均技术效率较高。然而，近一半的卫生中心技术上效率低下，这表明这些卫生中心的生产力还有进一步提高的空间。应鼓励减少（低于最佳水平）多余的行政人员数量，并选择适当的地点建设卫生中心（以覆盖更大的集水区人口），以提高卫生中心的生产力。
