A Performance Assessment Method for Hospitals: The Case of Municipal Hospitals in Angola
Over 60% of the recurrent budget of the Ministry of Health (MoH) in Angola is spent on the operations of the fixed health care facilities (health centres plus hospitals). However, to date, no study has been attempted to investigate how efficiently those resources are used to produce health services. Therefore the objectives of this study were to assess the technical efficiency of public municipal hospitals in Angola; assess changes in productivity over time with a view to analyzing changes in efficiency and technology; and demonstrate how the results can be used in the pursuit of the public health objective of promoting efficiency in the use of health resources. The analysis was based on a 3-year panel data from all the 28 public municipal hospitals in Angola. Data Envelopment Analysis (DEA), a non-parametric linear programming approach, was employed to assess the technical and scale efficiency and productivity change over time using Malmquist index.The results show that on average, productivity of municipal hospitals in Angola increased by 4.5% over the period 2000–2002; that growth was due to improvements in efficiency rather than innovation.
KeywordsHospital performance comparison Efficiency and productivity Data envelopment analysis Malmquist indices Angola/Africa
The authors are immensely grateful to Jehovah Jireh for His multifaceted support at all stages of preparing this manuscript; “Felix Masiye” (Harvard School of Public Health, USA) for the constructive comments; “Patricia Akweongo” (Navrongo Health Research Centre, Ghana) for follow-up on data collection; and to the anonymous reviewers of JMS for invaluable comments and suggestions. JMK and SB appreciate the enabling intellectual environment created by Dr Alimata J. Diarra-Nama in the Division of Health Systems and Services Development, WHO/AFRO. The data collection was funded by WHO/AFRO. The manuscript contains the analyses and views of the authors only and does not represent the decisions or stated policies of the institutions they work for.
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