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Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece

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Abstract

This is a study to measure the efficiency of the rural Health Centres (HCs) and their Regional Surgeries (RSs) of the 6th Health Prefecture (HP) of Greece, which covers Southern and Western Greece. Data Envelopment Analysis (DEA) was applied under Constant and Variable Returns to Scale, using a weight-restricted, output-oriented model, to calculate pure technical efficiency (PΤΕ), scale efficiency (SE) and total technical efficiency (TE). The selection of inputs, outputs and their relative weights in the model was based on two consecutive consensus panels of experts on Primary Health Care (PHC). Medical personnel, nursing personnel and technological equipment were chosen as inputs and were attributed appropriate weight restrictions. Acute, chronic and preventive consultations where chosen as outputs; each output was constructed by smaller subcategories of different relative importance. Data were collected through a questionnaire sent to all HCs of the covered area. From the 42 HCs which provided complete data, the study identified 9 as technical efficient, 5 as scale efficient and 2 as total efficient. The mean TE, PTE and SE scores of the HCs of the 6th Health Prefecture were 0.57, 0.67 and 0.87, respectively. The results demonstrate noteworthy variation in efficiency in the productive process of the HCs of Southern and Western Greece. The dominant form of inefficiency was technical inefficiency. The HCs of the 6th HP can theoretically produce 33 % more output on average, using their current production factors. These results indicated potential for considerable efficiency improvement in most rural health care units. Emphasis on prevention and chronic disease management, as well as wider structural and organisational reforms, are discussed from the viewpoint of how to increase efficiency.

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Acknowledgment

We are grateful to the members of the Delphi panel for providing their expertise on the inputs and outputs of Greek PHC, the former head of the 6th Health Prefecture professor Panagiotis Goumas for facilitating data collection and the administrations of the Health Centres of the 6th Health Prefecture for kindly providing the necessary information.

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Authors and Affiliations

  1. Health Centre of Gennadi, South Rhodes, 85109, Greece

    Nikolaos Oikonomou

  2. Centre for Health Services Research, Medical School, University of Athens, Athens, Greece

    Yannis Tountas & Kyriakos Souliotis

  3. Health Centre of Areopolis, Mani, Greece

    Argiris Mariolis

  4. Greek Union of General Practitioners, Athens, Greece

    Nikolaos Oikonomou & Argiris Mariolis

  5. Faculty of Social and Political Sciences, University of Peloponnese, Korinth, Greece

    Kyriakos Souliotis

  6. Department of Health Economics, National School of Public Health, Athens, Greece

    Kostas Athanasakis & John Kyriopoulos

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  1. Nikolaos Oikonomou
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  2. Yannis Tountas
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  3. Argiris Mariolis
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  4. Kyriakos Souliotis
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  5. Kostas Athanasakis
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  6. John Kyriopoulos
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Correspondence to Nikolaos Oikonomou.

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Oikonomou, N., Tountas, Y., Mariolis, A. et al. Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece. Health Care Manag Sci 19, 313–325 (2016). https://doi.org/10.1007/s10729-015-9324-4

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