东非公立医院的技术效率：系统评价与荟萃分析
Technical efficiency of public hospitals in east Africa: a systematic review and meta-analysis.
作者信息
Lamesgen Anteneh, Endalew Bekalu, Haimanot Aysheshim Belaineh, Tesfie Tigabu Kidie, Mazengia Elyas Melaku, Simegn Mulat Belay, Tilahun Werkneh Melkie, Birhanu Molla Yigzaw, Asmare Lakew, Geremew Habtamu, Mengie Muluye Gebrie
机构信息
Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
BMC Health Serv Res. 2025 Jan 6;25(1):26. doi: 10.1186/s12913-024-12166-7.
BACKGROUND
Hospitals usually encounter human, capital, and financial resource constraints which alerts the efficient use of allocated resources more than ever. Health system managers are required to identify inefficient hospitals and the drivers of the inefficiencies. Although there are multiple studies examining the efficiency of public hospitals in East Africa, their findings are often variable and inconsistent. Therefore, this study aimed to review published articles on technical efficiency of public hospitals in East African countries.
METHODS
A systematic search of published articles on the technical efficiency of public hospitals was employed using Pubmed, Cochrane library, and google scholar and thirteen studies were included to this review. The studies were described in terms of their publication year, sample size, inputs and outputs used in the efficiency analysis, and the technical efficiency levels. Finally, we assessed their quality and estimate the mean technical efficiency using meta-analysis.
RESULTS
The technical efficiency score of public hospitals varied across countries in east Africa which ranged from 0.64 ± 0.34 in Tanzania to 0.99 ± 0.03 in Ethiopia. The mean technical efficiency was 0.82 (95% CI = 0.56, 1.07) for primary hospitals and 0.88 (95% CI = 0.82, 0.95) for secondary level hospitals. Technical efficiency of public hospitals was negatively correlated with the number of hospitals (the sample size) and positively correlated with the number of inputs and outputs included in the efficiency analysis.
CONCLUSIONS
This review revealed that the technical efficiency of public hospitals in east Africa requires an improvement. To enable effective and efficient hospital management and improvement in hospital efficiency, health managers and policymakers must identify the drivers of hospital inefficiency. Systematic reviews on public hospital efficiency, which are currently rare in Africa, should be conducted on a much larger scale in order to create more, and validated information for use in policy-making.
TRIAL REGISTRATION
This review protocol was registered and approved by the international prospective register of systematic reviews with a Protocol ID: CRD42023444729.
背景
医院通常面临人力、资金和财务资源的限制，这比以往任何时候都更需要高效利用分配的资源。卫生系统管理者需要识别效率低下的医院及其低效率的驱动因素。尽管有多项研究考察了东非公立医院的效率，但研究结果往往参差不齐且相互矛盾。因此，本研究旨在回顾东非国家公立医院技术效率的已发表文章。
方法
通过PubMed、Cochrane图书馆和谷歌学术对已发表的关于公立医院技术效率的文章进行系统检索，本综述纳入了13项研究。从发表年份、样本量、效率分析中使用的投入和产出以及技术效率水平等方面对这些研究进行了描述。最后，我们评估了它们的质量，并使用荟萃分析估计平均技术效率。
结果
东非各国公立医院的技术效率得分各不相同，从坦桑尼亚的0.64±0.34到埃塞俄比亚的0.99±0.03不等。基层医院的平均技术效率为0.82（95%CI = 0.56, 1.07），二级医院为0.88（95%CI = 0.82, 0.95）。公立医院的技术效率与医院数量（样本量）呈负相关，与效率分析中包含的投入和产出数量呈正相关。
结论
本综述表明，东非公立医院的技术效率有待提高。为了实现有效的医院管理和提高医院效率，卫生管理者和政策制定者必须识别医院低效率的驱动因素。目前在非洲很少见的关于公立医院效率的系统评价应该在更大规模上进行，以便为政策制定创造更多经过验证的信息。
试验注册
本综述方案已在国际前瞻性系统评价注册库注册并获得批准，方案编号：CRD42023444729。
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