Technical Efficiency and Spatial Interdependence in Health Service Production in Kenya: Subnational Analysis for 47 County Governments

2021 ◽  
Author(s):  
Tom Achoki ◽  
Lawrence Were ◽  
Uzma Alam ◽  
Walter Ochieng ◽  
Tabitha Oanda ◽  
...  
Keyword(s):  
Health Service ◽  
Technical Efficiency ◽  
County Governments ◽  
Service Production ◽  
Spatial Interdependence ◽  
Subnational Analysis

Co-Creation and Healthcare Operations Management

2017 ◽  
pp. 400-414 ◽  
Author(s):  
Paul Lillrank
Keyword(s):  
Health Service ◽  
Operations Management ◽  
Service Research ◽  
Healthcare Operations ◽  
Service Production ◽  
Healthcare Operations Management

Service research has produced a definition that sees services as the integration of customers' and producers' resources to co-create value. Clear articulation of hitherto obscure phenomena enables sharper thinking on how such phenomena could be managed. This article discusses the implications of co-creation in healthcare, a sector of society that is perceived as difficult to manage. Co-creation is here understood as a variable that has different intensity and significance in different areas of healthcare. The Demand – Supply –based operating logic (DSO) is used to segment health service production into areas where co-creation appears in different roles.

scholarly journals Analysis on the Efficiency of Health Care Service Delivery and Influencing Factors in China: A Study Based on DEA-Malmquist Index and Tobit Model

2020 ◽  
Author(s):  
Kui Chen ◽  
Jun Ye
Keyword(s):  
Health Care ◽  
Health Service ◽  
Technical Efficiency ◽  
Total Factor Productivity ◽  
Influencing Factors ◽  
Health Care Service ◽  
Health Care Expenditure ◽  
Tobit Model ◽  
Utilization Rate ◽  
Factor Productivity

Abstract Objective: To evaluate the changeing trend and influencing factors of medical and health service supply efficiency in 31 provinces of China.Methods: According to the input-output relevant index data of medical and health service in China from 2009 to 2018, data envelopment analysis- Malmquist(DEA-Malmquist) was used to calculate the total factor productivity, technical efficiency, and technical change. Meanwhile, Tobit model to analyzed the main effective factors of medical and health service supply efficiency in ChinaResults: In 2018, 21 provinces including Beijing, Shanghai, Zhejiang and Guangdong were effective in DEA of China's medical and health supply efficiency. Jilin, Heilongjiang, Jiangsu and Shandong were weak DEA effective, while Shanxi, Inner Mongolia, Liaoning, Anhui, Fujian and Xinjiang were not DEA effective. From 2009 to 2018, the total factor productivity of China's medical and health service supply has been decreased steadily, which was mainly affected by technological changes. From the perspective of regions, the technical efficiency and pure technical efficiency of medical and health service supply was the highest in the east, followed by the central and the western region. Associate’s degree or above, gross regional domestic product, and health care expenditure were significantly associated with the increasing of medical and health service supply efficiency.Conclusions: According to their own conditions and constraints, all localities should take targeted measures to strengthen the allocation and management level of medical and health resources, promote technological progress, give full play to the role of education and economic development, increase the expenditure on medical and health care, improve the utilization rate of beds, shorten the average hospitalization days, effectively improve the efficiency of medical and health services supply, and better provide health care for people.

Getting out what we put in: productivity of the English National Health Service

2010 ◽  
Vol 6 (3) ◽  
pp. 313-335 ◽  
Author(s):  
Adriana Castelli ◽  
Mauro Laudicella ◽  
Andrew Street ◽  
Padraic Ward
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Productivity Growth ◽  
Survival Rates ◽  
Output Growth ◽  
National Accounts ◽  
Service Production ◽  
English National Health ◽  
English National Health Service

AbstractMany countries are incorporating direct measures of non-market outputs in the national accounts. For any particular output to be included there has to be data about it for two adjacent periods. This is problematic because the classification of non-market outputs is often subject to wholesale revision. We outline the challenges associated with classification changes and propose a solution. To illustrate we construct output and input indices and estimate productivity growth of the English National Health Service (NHS) for the period 2003–2004 to 2007–2008. Our index of output growth incorporates all care provided to NHS patients and captures improvements in survival rates, waiting times and disease management. We find that more patients are being treated and the quality of the care they receive has been improving. We implement our approach to dealing with changes as to how health services are defined and show what effect this has on estimates of output growth. Our index of input growth captures all labour, intermediate and capital inputs into health service production and we improve on how capital has been measured in the past. Inputs have increased over time but there has also been a slowdown since 2005–2006, primarily the result of a levelling off in staff recruitment and less reliance on the use of agency staff. Productivity is assessed by comparing output growth with growth in inputs, the net effect being constant productivity growth between 2003–2004 and 2007–2008.

scholarly journals The Technical Efficiency of Community Health Service Centers in Wuhan, China: Estimation and Policy Implications

2018 ◽  
Vol 55 ◽  
pp. 004695801881297 ◽  
Author(s):  
Xinliang Liu ◽  
Quan Wang ◽  
Barsanti Sara ◽  
Wei Yang ◽  
Siping Dong ◽  
...  
Keyword(s):  
Health Service ◽  
Community Health ◽  
Technical Efficiency ◽  
Health Resources ◽  
Efficiency Score ◽  
Community Health Service ◽  
Policy Implications ◽  
Third Party ◽  
Research Subjects ◽  
Wuhan City

This study seeks to measure the technical efficiency of Community Health Service Centers (CHSCs) in Wuhan City, China, to propose some policy recommendations to improve the efficiency of CHSCs. A total of 46 CHSCs in Wuhan City were included in the study as research subjects. Data of 11 selected input and output indicators were collected from Hubei Provincial Health and Family Planning Commission. R3.2.1 statistical software was used to estimate the efficiency scores of CHSCs using Bootstrap-Data Envelopment Analysis (DEA), and, on average, the bias-corrected technical efficiency score is found to be 0.7845. All the bias-corrected scores of CHSCs are lower than classical scores. At both local and regional level, large gaps exist in relative technical efficiency scores among the CHSCs, and 12 out of 46 CHSCs (26.09%) have efficiency scores at or below average levels. The results indicate big potential for the CHSCs in Wuhan to improve their technical efficiency, such as the optimization of health resources allocation, capacity building, information system strengthening, third party performance evaluation, and mechanisms design, and so on.

scholarly journals Technical Efficiency of Maternal and Reproductive Health Services in Public Hospitals of Oromia Regional State, Ethiopia

2019 ◽  
Vol 12 ◽  
pp. 117863291983763 ◽  
Author(s):  
Kiddus Yitbarek ◽  
Ayinengida Adamu ◽  
Gebeyehu Tsega ◽  
Yibeltal Siraneh ◽  
Belay Erchafo ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Health Services ◽  
Technical Efficiency ◽  
Reproductive Health Service ◽  
Public Hospitals ◽  
Maternal Health Service ◽  
Reproductive Health Services ◽  
Catchment Population ◽  
Regional State

As the Ethiopian health system faced critical resource constraints, wise use of the available health resources is a priority agenda. Therefore, our study aimed to assess technical efficiency of maternal and reproductive health services in public hospitals of Oromia regional state, Ethiopia. Two-stage data envelopment analysis was performed among 14 hospitals with input orientation and variable returns to scale assumptions. Technical efficiency scores were computed at the first stage, and predictors were determined using Tobit regression at the second stage. The assessment revealed that 12 (85.7%) hospitals were pure technical efficient and 9 (64.29%) hospitals were scale efficient. Level (primary/general) (β = 1.17, 95% confidence interval [CI] = 0.16-2.18), service years (β = 0.02, 95% CI = 0.003-0.03), and size of catchment population (β = 5.58E–07, 95% CI = 2.95E–08 to 1.09E–06) were positively associated with technical efficiency of maternal and reproductive health service, whereas average waiting time for maternal health service (β = –0.03, 95% CI = –0.05 to −0.01) was negatively associated with efficiency. In conclusion, most of the hospitals were technically efficient and around two-thirds were operating scale efficient. Allocation of more resources to older secondary hospitals with larger catchment population could result in more efficient use of resources for maternal and reproductive health service delivery.

scholarly journals The Technical Efficiency of Essential Public Health Services Provision in China: Based on a Panel Data Analysis

2021 ◽  
Author(s):  
Fankun Cao ◽  
Yan Xi ◽  
Tongyu Bai ◽  
Shushan Dong ◽  
Qiang Sun
Keyword(s):  
Public Health ◽  
Health Service ◽  
Health Services ◽  
Technical Efficiency ◽  
Public Health Service ◽  
Shandong Province ◽  
Scale Efficiency ◽  
Public Health Services ◽  
Service Program ◽  
Essential Public Health Services

Abstract BackgroundProviding essential public health services equally to all Chinese is one of the objectives of health system reform since 2009. Essential public health service program is to provide a package of public health services for all Chinese freely by the primary health institutions. Since the implementation of the national essential public health service program, the level of funding and the intensity of input have been continuously increasing. However, in the context of China’s economic development entering a new normal phase, the growth rate of funding for essential public health services has far exceeded the growth rate of GDP and central fiscal revenue, and the sustainability of the development of national essential public health service programs has been seriously challenged. Improving the efficiency of resource use may be an effective way to ensure the continuation of the national essential public health service program. But little evidence was available about technical efficiency in essential public health services provision. Therefore, the aim of this study was to assess the technical efficiency of essential public health services in Shandong province.Methods This study was a retrospective study based on the historical panel data of Shandong Province, East China. The data came from the Shandong Provincial Essential public health Service Program Database of the Medical Management Center of Shandong Provincial Health Commission, which covered all 137 counties and districts in 16 cities of Shandong Province from 2014 to 2019. The principal component analysis method was used to classify multiple output indicators of essential public health service programs, so as to achieve the purpose of generic index extraction. The efficiency coefficient transformation analysis method was used to transform the data of each principal component score after the principal component analysis of the input index of essential public health service programs. The CCR model and BBC model in the Data Envelopment Analysis （DEA） method were used to calculate the comprehensive technical efficiency, pure technical efficiency and scale efficiency of essential public health services.ResultsThe average comprehensive technical efficiency of essential public health services in Shandong Province showed a slight downward trend from 0.8896 in 2014 to 0.8753 in 2019. The average pure technical efficiency of essential public health services was kept at 0.99. The average scale efficiency of essential public health services showed a slight downward trend from 0.8871 in 2014 to 0.8744 in 2019. The proportion of counties and districts with the comprehensive technical efficiency of essential public health services in Shandong Province was increased from 15.3% in 2014 to 21.9% in 2019. But the proportion of counties with the pure technical efficiency decreased from 38.0% in 2014 to 35.9% in 2019. The proportion of counties with scale efficiency of essential public health services showed an upward trend, rising from 14.8% in 2014 to 22.6% in 2019, increasing by 7.8%.The ratio of effective comprehensive technical efficiency of essential public health services in Shandong Province to all counties and districts has shown a upward trend. Among them, the proportion of counties with effective pure technical efficiency was higher than the proportion of counties with efficient scale efficiency each year. At the same time, the increase in the proportion of counties with effective scale efficiency was higher than the increase in the proportion of counties with effective pure technical efficiency. The increasing proportion of effective counties in the comprehensive technical efficiency of essential public health services in Shandong Province was mainly due to the increasing proportion of effective counties in the scale efficiency and the good performance of effective counties in the pure technical efficiency. This showed that, although the investment scale of Shandong Province in the counties was gradually sufficient, there was still a phenomenon of insufficient resource investment in most counties. That would ultimately affect the sustainability of the implementation of essential public health services.Conclusion The research have demonstrated that the technical efficiency of essential public health services in Shandong Province has shown a slight downward trend, and the main reason for its downward trend was the decline in scale efficiency. The scale efficiency in essential public health services affected the technical efficiency and would ultimately threaten the sustainable development of essential public health services. It is recommended that future research directions should focus on the influencing factors and improvement measures of the scale efficiency of essential public health services.

Dysphagia Services in Schools: Applying Special Education Requirements to a Health Service

2009 ◽  
Vol 18 (3) ◽  
pp. 86-90 ◽  
Author(s):  
Lissa Power-deFur
Keyword(s):  
Special Education ◽  
Health Service ◽  
Due Process ◽  
Due Process Hearings ◽  
Related Services ◽  
Eligibility Determination ◽  
Legal Provisions ◽  
Provision Of Services ◽  
Related Service ◽  
Specially Designed Instruction

Abstract School speech-language pathologists and districts frequently need guidance regarding how the legal provisions of special education affect the needs of children with dysphagia. This article reviews key principles of special education that guide eligibility determination and provision of services to all children. In the eligibility process, the school team would determine if the child's disability has an adverse effect on his/her education program and if the child needed special education (specially designed instruction) and related services. Dysphagia services would be considered a related service, a health service needed for the child to benefit from specially designed instruction. The article concludes with recommendations for practice that stem from a review of due process hearings and court cases for children with disabilities that include swallowing.

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