Factors affecting primary health care centers’ economic and production efficiency
- 457 Downloads
Little is known about the efficiency of health centers, despite their central role in primary health care strategy for several countries. This study evaluates the health centers in Greece, and identifies factors impeding the achievement of efficiency, with the aim of determining how their efficiency could be improved. Two alternative conceptual models are used to ensure the consistency of the efficiency results: one model is focusing on production efficiency and the other on economic efficiency. Subsequently a second stage analysis is performed to account for the impact of explanatory variables on efficiency. The use of DEA models alongside with bootstrap techniques allows calculating more accurately the efficiency scores that can reflect the performance of health centers more properly. The main drivers of health centers’ technical efficiency for both conceptual models were the location characteristics, the population growth, the mortality rate and the competition. The scale efficiency of health centers in production model is reflected by the size of their respective covered populations, the location characteristics and the mortality rate while the economic model is affected by their size, the location characteristics and the percentage of population working in agriculture. Determining how these variables influence on efficiency is essential for determining performance improvement strategies.
KeywordsBootstrapped DEA Truncated regression analysis Primary healthcare
This research has been co-funded by the European Union (European Social Fund) and Greek national resources under the framework of the ‘Archimedes III’ project of the ‘Education and Lifelong Learning’ Operational Programme.
- Amado, C., & Dyson, R. (2008). On comparing the performance of primary care providers. European Journal of Operational Research, 185, 915–932.Google Scholar
- Coelli, T., Prasada, D. S. R., & Battese, G. (2005). An introduction to efficiency and productivity analysis. Boston: Kluwer.Google Scholar
- Economou, C. (2010). Health systems in transition: Greece. Health system review. WHO/EURO, European Observatory on Health Systems and Policies, CopenhagenGoogle Scholar
- Fragkiadakis, G., Doumpos, M., Zopounidis, C., & Germain, C. (2014). Operational and economic efficiency analysis of public hospitals in Greece. Annals of Operations Research, 1–20. doi: 10.1007/s10479-014-1710-7.
- Health Map. (2005). Greek Ministry of Health homepage on the Internet updated.Google Scholar
- Sissouras, A., Mitropoulos, I., & Gounaris, Ch. (2000, June). Evaluating the efficiency of health care units: The case of the Greek primary care centres. In A. Javor, E. van Eimeren, & G. Duru (Eds.), Proceedings of the 7th international conference on system science in health care, Budapest.Google Scholar