University of Montpellier, Montpellier Recherche en Economie, Avenue Raymond Dugrand, 34960 Cedex 2, Montpellier, France.
BETA, University of Strasbourg, Strasbourg, France.
BMC Health Serv Res. 2024 Oct 11;24(1):1218. doi: 10.1186/s12913-024-11688-4.
Burkina Faso faces many challenges in the health domain, with no real opportunity for an increase in public health expenditures. In Burkina Faso, as in all low-income countries, health spending efficiency is crucial. The objective of this paper is to assess the efficiency of Advanced Medical Centers (AMCs)-which correspond to district hospitals-in Burkina Faso over the 2017-2020 period and identify the factors that promote-or, on the contrary, limit-the efficiency of these health structures.
We first assessed the efficiency level of the 45 AMCs running in the country between 2017 and 2020 using a bootstrap Data Envelopment Analysis (DEA) methodology. Inputs include the number of doctors, nurses, other medical staff, non-medical staff, and beds, while output variables correspond to the number of inpatients, surgeries, outpatients, and inpatient days. In a second step, determinants of AMC's efficiency levels were explored using a double-bootstrap procedure. The roles of AMCs' internal and environmental factors were both considered.
We found a mean efficiency score of 0.51 over the study period, indicating that AMCs could have almost doubled their healthcare production without needing additional resources. The size, education level, and health status of the covered population and the density of the healthcare supply in the district appeared to be the driving factors of AMCs' efficiency.
Our results indicate that improving the efficiency of AMCs should be a high-level priority for the Burkinabe health policy. Resources could be reallocated across AMCs to increase the overall efficiency of the health system.
布基纳法索在卫生领域面临诸多挑战，几乎没有增加公共卫生支出的机会。在布基纳法索，和所有低收入国家一样，卫生支出效率至关重要。本文旨在评估 2017-2020 年期间布基纳法索高级医疗中心（AMC）——对应地区医院——的效率，并确定促进或限制这些卫生机构效率的因素。
我们首先使用 bootstrap 数据包络分析（DEA）方法评估了 2017 年至 2020 年间全国 45 家 AMC 的效率水平。投入包括医生、护士、其他医务人员、非医务人员和床位数量，而产出变量则对应于住院病人、手术、门诊和住院天数。在第二步中，使用双重 bootstrap 程序探讨了 AMC 效率水平的决定因素。同时考虑了 AMC 的内部和环境因素的作用。
我们发现，在研究期间的平均效率得分为 0.51，这表明 AMC 可以在不增加额外资源的情况下将其医疗保健产量提高近一倍。覆盖人口的规模、教育水平和健康状况以及该地区医疗供应的密度似乎是 AMC 效率的驱动因素。
我们的结果表明，提高 AMC 的效率应该是布基纳法索卫生政策的首要重点。资源可以在 AMC 之间重新分配，以提高整个卫生系统的效率。
