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Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis
BACKGROUND: Cambodia is undergoing a series of reforms with the objective of reaching universal health coverage. Information on the causes of inefficiencies in health facilities could pave the way for a better utilization of limited resources available to ensure the best possible health care for the...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463960/ https://www.ncbi.nlm.nih.gov/pubmed/37641129 http://dx.doi.org/10.1186/s12913-023-09570-w |
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author | Beiter, Dominik Koy, Sokunthea Flessa, Steffen |
author_facet | Beiter, Dominik Koy, Sokunthea Flessa, Steffen |
author_sort | Beiter, Dominik |
collection | PubMed |
description | BACKGROUND: Cambodia is undergoing a series of reforms with the objective of reaching universal health coverage. Information on the causes of inefficiencies in health facilities could pave the way for a better utilization of limited resources available to ensure the best possible health care for the population. OBJECTIVES: The purpose of this study is to evaluate the technical efficiency of health centers and the determinants for inefficiencies. METHODS: This cross-sectional study used secondary data from a costing study on 43 health centers in six Cambodian provinces (2016–2017). Firstly, the Data Envelopment Analysis method with output-orientation was applied to calculate efficiency scores by selecting multiple input and output variables. Secondly, a tobit regression was performed to analyze potential explanatory variables that could influence the inefficiency of health centers. RESULTS: Study findings showed that 18 (43%) health centers were operating inefficiently with reference to the variable returns to scale efficiency frontier and had a mean pure technical efficiency score of 0.87. Overall, 22 (51%) revealed deficits in producing outputs at an optimal scale size. Distance to the next referral hospital, size and quality performance of the health centers were significantly correlated with health center inefficiencies. CONCLUSION: Differences in efficiency exist among health centers in Cambodia. Inefficient health centers can improve their technical efficiency by increasing the utilization and quality of health services, even if it involves higher costs. Technical efficiency should be continuously monitored to observe changes in health center performance over time. |
format | Online Article Text |
id | pubmed-10463960 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104639602023-08-30 Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis Beiter, Dominik Koy, Sokunthea Flessa, Steffen BMC Health Serv Res Research BACKGROUND: Cambodia is undergoing a series of reforms with the objective of reaching universal health coverage. Information on the causes of inefficiencies in health facilities could pave the way for a better utilization of limited resources available to ensure the best possible health care for the population. OBJECTIVES: The purpose of this study is to evaluate the technical efficiency of health centers and the determinants for inefficiencies. METHODS: This cross-sectional study used secondary data from a costing study on 43 health centers in six Cambodian provinces (2016–2017). Firstly, the Data Envelopment Analysis method with output-orientation was applied to calculate efficiency scores by selecting multiple input and output variables. Secondly, a tobit regression was performed to analyze potential explanatory variables that could influence the inefficiency of health centers. RESULTS: Study findings showed that 18 (43%) health centers were operating inefficiently with reference to the variable returns to scale efficiency frontier and had a mean pure technical efficiency score of 0.87. Overall, 22 (51%) revealed deficits in producing outputs at an optimal scale size. Distance to the next referral hospital, size and quality performance of the health centers were significantly correlated with health center inefficiencies. CONCLUSION: Differences in efficiency exist among health centers in Cambodia. Inefficient health centers can improve their technical efficiency by increasing the utilization and quality of health services, even if it involves higher costs. Technical efficiency should be continuously monitored to observe changes in health center performance over time. BioMed Central 2023-08-28 /pmc/articles/PMC10463960/ /pubmed/37641129 http://dx.doi.org/10.1186/s12913-023-09570-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Beiter, Dominik Koy, Sokunthea Flessa, Steffen Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis |
title | Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis |
title_full | Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis |
title_fullStr | Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis |
title_full_unstemmed | Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis |
title_short | Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis |
title_sort | improving the technical efficiency of public health centers in cambodia: a two-stage data envelopment analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463960/ https://www.ncbi.nlm.nih.gov/pubmed/37641129 http://dx.doi.org/10.1186/s12913-023-09570-w |
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