Technical efficiency and its influencing factors in Malaysian hospital pharmacy services

  • Nurhafiza Md Hamzah
  • Kok Fong SeeEmail author


Various pharmacy services are offered in public health facilities, ranging from distributive activities (dispensing) to patient-oriented services (pharmaceutical care). These activities are monitored through indicators established at the national level. In Malaysia, the indicators have not been transformed into a measurement of hospital pharmacy service efficiency. The main objectives of this study were to assess the relative performance of hospital pharmacy services and to investigate the factors that may affect the performance levels. Double-bootstrap data envelopment analysis was applied to measure the technical efficiency levels of 124 public hospital pharmacies in 2014. An input-oriented variable returns to scale model was adopted in the study, while bootstrap truncated regression was conducted to identify the factors that may explain the differences in the efficiency levels. The average bias-corrected technical efficiency score varies according to the hospital size (0.84, 0.78 and 0.82 in small, medium and large hospitals, respectively). The hospital size, hospital age, urban location and information technology are important determinants of the efficiency levels. The study contributes to establishing baseline technical efficiency information for public hospital pharmacy services in Malaysia. The measurement of hospital pharmacy efficiency can guide future policy making to improve performance and ensure the optimum level of available resources.


Hospital pharmacy services Technical efficiency Double-bootstrap DEA, Malaysia 



The authors wish to thank the Director General of Health, Ministry of Health Malaysia, for permission to produce this paper. The authors express their gratitude to the team members from the Pharmaceutical Services Programme, Ministry of Health Malaysia, who aided in the data collection. The authors also thank the expert panel members for their invaluable inputs, and the representatives from hospital pharmacy departments for providing the required data. The authors are grateful to the Pharmaceutical Services Programme for funding this study. The corresponding author thanks the Taiwan Fellowship, Ministry of Foreign Affairs, Republic of China (Taiwan) and the Universiti Sains Malaysia’s Research University Grant (1001/PJJAUH/816268) for the opportunity to perform research in Taiwan and Germany during part of the period in which this research was conducted. All remaining errors are the responsibility of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pharmaceutical Services DivisionMinistry of Health MalaysiaPetaling JayaMalaysia
  2. 2.Economics Programme, School of Distance EducationUniversiti Sains MalaysiaPulau PinangMalaysia

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