Are public hospitals reforming efficiently in West Bank?

Sultan, Wasim I M; Crispim, José

doi:10.1186/s13031-018-0180-y

Cited by 10 publications

(17 citation statements)

References 45 publications

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“…The number of healthcare institutions and beds were commonly chosen to represent capital investment [ 33 , 42 , 46 – 49 ]. Regarding labor variables, health workers [ 13 , 17 , 42 , 44 – 47 , 50 ], health technical workers [ 30 , 33 , 36 , 42 , 45 , 48 , 49 ], physicians [ 28 – 30 , 36 , 41 , 43 – 45 , 50 ], and nurses [ 17 , 28 , 30 , 36 , 41 , 42 , 44 , 45 ] were often regarded as types of labor investment. In the selection of output indicators, there are two main categories of expected and undesirable outputs.…”

Section: Introductionmentioning

confidence: 99%

“…For data availability issues, most studies opt for expected indicators when conducting analysis. The number of outpatient visits or outpatient and emergency visits [ 13 , 28 , 30 , 36 , 41 , 42 , 44 – 49 , 51 ], inpatient visits or discharged visits [ 28 , 29 , 36 , 41 – 44 , 46 – 48 , 51 ] and revenue [ 17 , 33 ] are usually regarded as expected outputs, and infection incidence or infectious patients and patient or population mortality [ 36 , 50 , 52 ] are regarded as undesirable outputs. Kohl S and Schoenfelder J et al pointed out that it is of great importance to distinguish between absolute and relative data to prevent biased conclusions [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

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Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Fan

et al. 2022

Int J Equity Health

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Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation. Methods Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Fan

et al. 2022

Int J Equity Health

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“…Patients’ experiences were more positive towards hospitals of NGOs and outside In the West Bank, Sultan and Crispim claimed that public hospitals improved their reform efficiency from 75% to 80%, however, still quality of hospital care is under question. 32 The quality of working life at governmental hospital is moderate as stated by 66% resident doctors in which the highest was reported in Palestine medical complex and the lowest was in Hebron hospital. 33 In the case of Gaza strip, substantial improvement is seen but comprehensiveness of care remained a major concern, availability of essential medicine and shortage of healthcare workers.…”

Section: Discussionmentioning

confidence: 98%

Experiences of Palestinian patients with hospital services: a mixed-methods study

et al. 2023

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BackgroundThis study aimed at assessing patient experiences with hospital services and key factors associated with better experiences.MethodsThe study design is cross-sectional supported by qualitative interviews. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was used as data collection instrument. A convenience sample of 391 volunteers aged ≥18 years participated in this study. Qualitative interviews were conducted with patients and healthcare providers to further enrich and explain the quantitative results.ResultsThe average age of the sample was 41.34, SD (16.4), range (18–87). Females represented 61.9% of the whole sample. Almost 75% were from the West Bank and 25% from the Gaza Strip. The majority of respondents reported that doctors and nurses were respectful, listened to them and explained clearly to them always or most of the time. Only 29.4% of respondents were given written information about the symptoms they may have after discharge from the hospital. Factors that were independently associated with higher scores on the HCAHPS scale were; being females (coef: 0.87, 95% CI: 0.157 to 1.587, p=0.017), being healthy (coef: −1.58, 95% CI: −2.458 to −0.706, p=0.000), being with high financial status (coef: 1.51, 95% CI: 0.437 to 2.582, p=0.006), being from Gaza (coef: 1.45, 95% CI: 0.484 to 2.408, p=0.003) and who visited hospitals outside of Palestine (coef: 3.37, 95% CI: 1.812 to 4.934, p=0.000). Overcrowding, weak organisational and management processes, and inadequate supply of goods, medicines, and equipment were reported factors impeding quality services via in-depth interviews.ConclusionsThe overall hospital experiences of Palestinian patients were moderate but varied significantly based on patients’ factors such as sex, health status, financial status and residency as well as by hospital type. Hospitals in Palestine should invest more in improving their services including communications with patients, the hospital environment and communication with patients.

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“…The number of health care facilities and the number of beds were generally chosen to represent capital investment. Health workers, health technology workers, and physicians are used as human investments; for the selection of output indicators, most choose the number of outpatient visits or outpatient and emergency visits, and hospitalizations or discharges [3,[36][37][38][39]. In this study, based on the existing literature and the corresponding indicators available, the number of hospitals (I1), the number of health technicians (I2) and the actual number of beds (I3) were selected as input indicators, and the number of visits (number of outpatient and emergency treatment) (O1), discharges (O2) and bed utilization rate (O3) were selected as output indicators in two dimensions: service volume and economic e ciency (Table 1).…”

Section: Stage 2: Hospital Service E Ciency Evaluationmentioning

confidence: 99%

Efficiency and equity of hospital services in mainland China: based on data from 2017 to 2021

Kou

Mei

et al. 2023

Preprint

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Background: Hospitals are an essential part of the health care system. The purpose of this study is to evaluate the equity and service efficiency of health resource allocation in the hospital service system of 31 provinces (municipalities directly under the central government and autonomous regions) in mainland China from 2017 to 2021, and to analyze the influencing factors of hospital service efficiency to provide a reference for rational allocation of hospital health resources and improvement of hospital service efficiency. Methods: Equity of allocation of hospital health resources in mainland China was evaluated in three dimensions using the Gini coefficient and Lorenz curve. Hospital service efficiency was calculated by output-oriented super efficiency slack-based model-data envelopment analysis (SE-SBM-DEA) model and DEA-based Malmquist total factor productivity index (MTFP), and the influencing factors of hospital service efficiency were analyzed by panel data regression. Results: The number of hospitals in mainland China grew from 31056 to 36570 between 2017 and 21st. The equity ranking of the dimensions of hospital health resource allocation was Demographic > Economic > Geographic. However, the curvature of the demographic and economic dimensions is smaller compared to the curvature of the Lorenz curve for the geographic dimension. The demographic dimension has the lowest average Gini coefficient (0.167), followed by the economic (0.295) and the geographical (0.616). The 2017-2021 MTFP results show that none of the DMU efficiency values exceed 1. SE-SBM-DEA results show 15 DMUs in 2021 with total factor productivity above 1. The five-year average efficiency values ranked West (0.851) > East (0.834) > Central (0.673); Five influential factors identified by panel data regression analysis, Among them, X1(The proportion of urban population), X3(The percentage of illiterate population to total aged 15 and over) and X10(The proportion of the volume of medical service in primary medical facilities) have a positive relationship with hospital service efficiency, and X5(The level of per capital outpatient and emergency treatment expenditure) and X8(The proportion of hospital personnel) have a negative relationship with hospital service efficiency. Conclusion: After five years of development, the hospital service system in mainland China has grown significantly in number and size, but there are still differences in the allocation of hospital health resources between the East and the West, and intra-regional differences remain large. The overall level of efficiency in hospital services over the last five years was poor, with the West overtaking the East as the region with the highest five-year average. The regression model verified the effect of some factors on hospital service efficiency, and the effect of disadvantaged groups on hospital service efficiency was not significant (P>0.05).

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Are public hospitals reforming efficiently in West Bank?

Cited by 10 publications

References 45 publications

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Experiences of Palestinian patients with hospital services: a mixed-methods study

Efficiency and equity of hospital services in mainland China: based on data from 2017 to 2021

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