Alhidary Ahmed, Arturo Pesigan, Al-Waleedi Ali, Coulibaly-Zerbo Ferima, Faisal Omar, Al Mansour Mahammad, Al-Mudwahi Ali, Rajamanar Mohammed, Bisalinkumi Ezechiel, Al-Falahi Eshrak, Ali Latifah
EM/ACO/YEM/WHO Country Office, Sana'a,Yemen.
Department of Community Medicine, Faculty of Medicine, University of Aden, Aden, Yemen.
PLoS One. 2025 May 5;20(5):e0316583. doi: 10.1371/journal.pone.0316583. eCollection 2025.
The balance between wise use resources and provision of health services are crucial for the sustainability of services and ensuring value for money. Thus, it is essential to regularly monitor the status of health services to address any variations that arise. This study aimed to evaluate the performance of Therapeutic Feeding Centers (TFCs) by examining their efficiency, effectiveness, and beds utilization and assessing related factors. A retrospective quantitative study was conducted in 94 TFCs in Yemen from January to December 2022. Clinical outcomes like recovery rates, death rate, and default rate were measured, alongside with the dependent variables of efficiency, bed utilization, and effectiveness as a matrix to evaluate the TFC performance. The Data Envelopment Analysis model was used to measure technical efficiency, the Pabon Lasso model was used to classify the performance levels. The regression coefficient was used to determine associated factors. A total of 26,887 records of Sever-Acuate-Malnutrition children were reviewed. The results indicated that the recovered rate 90%, default rate 3.6%, death rate 1. 3%. The average effectiveness scores were 95%, technical efficiency 73%, and bed utilization rate 63%, the average performance was 82%. Moreover, the study found a positive weak correlation between effectiveness and efficiency (r = .190, n = 94, p = .008), and the efficiency was influenced by the Occupancy Bed Rate, Bed Turnover Rate and Length of Stay, F (3,90) =123.90, P < 0.001, R2 = .805. The results indicate that the TFCs performed well overall and even exceeding Sphere standards thresholds for the outcome and effectiveness indicators. However, there is still a need to improve efficiency and bed utilization to meet the standards. The study indicated to a positive correlation between effectiveness and efficiency, although no relationship has been found between them. To further performance enhancement, the ministry of health and its partners must optimize resources utilization.
合理利用资源与提供卫生服务之间的平衡对于服务的可持续性和确保资金价值至关重要。因此，定期监测卫生服务状况以应对出现的任何变化至关重要。本研究旨在通过检查治疗性喂养中心（TFCs）的效率、有效性和床位利用率并评估相关因素来评估其绩效。2022年1月至12月在也门的94个TFCs开展了一项回顾性定量研究。测量了康复率、死亡率和违约率等临床结果，同时将效率、床位利用率和有效性作为评估TFC绩效的矩阵的因变量。数据包络分析模型用于衡量技术效率，帕邦套索模型用于对绩效水平进行分类。回归系数用于确定相关因素。共审查了26887例重度急性营养不良儿童的记录。结果显示，康复率为90%，违约率为3.6%，死亡率为1.3%。平均有效性得分95%，技术效率73%，床位利用率63%，平均绩效82%。此外，研究发现有效性与效率之间存在弱正相关（r = 0.190，n = 94，p = 0.008），效率受占用床位率、床位周转率和住院时间的影响，F(3,90)=123.90，P < 0.001，R2 = 0.805。结果表明，TFCs总体表现良好，甚至超过了《全球人道主义应急最低标准》的结果和有效性指标阈值。然而，仍有必要提高效率和床位利用率以达到标准。研究表明有效性与效率之间存在正相关，尽管尚未发现它们之间存在关联。为进一步提高绩效，卫生部及其合作伙伴必须优化资源利用。
