Impact of health sector reforms on hospital productivity in Turkey

Mollahaliloglu, Saleh; Kavuncubaşı, Şahin; Yilmaz, Fikriye; Younis, Mustafa Z; Şimşek, Fatih Mehmet; Kostak, Mustafa; Yıldırım, Selami; Nwagwu, Emeka

doi:10.1108/ijotb-03-2018-0025

Cited by 15 publications

(8 citation statements)

References 28 publications

(29 reference statements)

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“…Studies in Turkey showed that HTP implementation in this country was successful and had a significant impact on hospitals’ efficiency and productivity. Mollahaliloglu concluded that hospital efficiency and productivity increased following HTP implementation [ 35 ]. The Sahin study has shown that Turkish public hospitals’ productivity improved from 2005 to 2008 [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of Iran’s health transformation plan on hospital performance: Kerman province

et al. 2021

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Iran has performed Health Transformation Plan (HTP) from 2014 to obtain its defined goals. This study assesses and compares university and non-university hospitals’ efficiency and productivity in Kerman provinces, Iran. The data of 19 selected hospitals, two years before and two years after Health Transformation Plan, was collected in this cross-sectional study. These data included the variables of physician and nurse number, and active beds as inputs and bed occupancy rate and inpatient admission adjusted with the length of stay as outputs. Data Envelopment Analysis method used to measure hospital efficiency. Malmquist Productivity Index is used to measure the efficiency change model before and after the plan. The efficiency and effect of the plan on hospitals’ efficiency and productivity were assessed using R software. The results indicated that all hospitals’ average efficiency before the HTP was 0.843 and after the HTP was increased to 0.874. However, it was not significant (P>0.05). Productivity also had a decreasing trend. Based on the DEA method results, it was found that university and non-university hospitals’ efficiency and productivity did not increase significantly after the HTP. Therefore, it is recommended that attention be paid to hospitals’ performance indicators regarding how resources are allocated and decisions made.

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Section: Discussionmentioning

confidence: 99%

The effect of Iran’s health transformation plan on hospital performance: Kerman province

et al. 2021

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“…In this sense, it is worth mentioning that in recent years many countries have implemented reforms marked by financial restructuring of their health systems (increasing concentration by allowing mergers of hospitals) to enhance productivity, solve equity problems and facilitate access to health services. Therefore, it is becoming increasingly common to find studies that use frontier techniques such as DEA or MPI to evaluate the impact of those reforms [52,56,[71][72][73]. Therefore, the methodology proposed in this study could also be applied for this purpose in the event that the Panamanian authorities decide to implement some specific reforms regarding the structure of its health system in the near future.…”

Section: Discussionmentioning

confidence: 99%

Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?

Ferrera

García-García

Lau-Cortés

et al. 2021

IJERPH

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In Latin American and Caribbean countries, the main concern of public health care managers has been traditionally placed on problems related to funding, payment mechanisms, and equity of access. However, more recently, there is a growing interest in improving the levels of efficiency and reducing costs in the provision of health services. In this paper we focus on measuring the technical efficiency and productivity change of public hospitals in Panama using bootstrapped Malmquist indices, which allows us to assess the statistical significance of changes in productivity, efficiency, and technology. Specifically, we are interested in comparing the performance of hospitals belonging to the two different management schemes coexisting in the country, the Social Security Fund (SSF) and the Ministry of Health (MoH). Our dataset includes data about 22 public hospitals (11 for each model) during the period between 2005 and 2015. The results showed that the productivity growth of hospitals belonging to the SSF has been much higher than that of the hospitals belonging to the Ministry of Health over the evaluated period (almost 4% compared to 1.5%, respectively). The main explanation for these divergences is the superior growth of technological change in the former hospitals, especially in the final years of the evaluated period.

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“…It was also found that the TFP average was below 1 in 2014-2015 and above 1 in other periods. Mollahaliloglu et al (2018) in the study conducted with MPI analysis to examine the results of the health transformation program in Turkey; the results were found to have a positive effect on hospital efficiency. The years 2001-2009 were researched.…”

Section: Discussionmentioning

confidence: 99%

Examination of Efficiency Change of Provincial Hospitals in Azerbaijan with Malmquist Index

Selamzade

Yüksel

2021

Journal of International Health Sciences and Management

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The level of development in health is an important criterion for countries. In a study aimed at measuring the performance of the health system in Azerbaijan on a provincial basis, the change in health efficiency of 56 cities between 2015-2019 was analyzed with the Malmquist Total Factor Productivity Index (MPI). As an input variable, the number of hospital beds, the number of health workers and the number of physicians were used in the provinces. The values used in input variables are figures per 10,000 people. As an output variable, the number of deaths of infants (under 1 year old), the number of deaths and the number of outpatient clinics were determined. The values used in the output variables are figures per 1000 people. The average MPI scores of the provinces covered by the study were 0.998 in 2015-2016, 1.002 in 2016-2017, 1.036 in 2017-2018 and 1.027 in 2018-2019. Out of the sample cluster of 56 provinces, Total Factor Productivity (TFP) increased in 36 (64.29%), remained constant in 1 (1.79%) and decreased in 19 (33.93%). Furthermore, TFP values were highest in Qazakh (20.6%), Aghdam (12,7) and Dashkesen (12,2). As a result of the study, it was found that there was an increase in productivity levels during the time period when the health performance of the provinces in Azerbaijan was evaluated. For this reason, it is proposed to develop actions and policies aimed at improving performance in low-productivity provinces and to allocate resources taking into account social needs.

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Impact of health sector reforms on hospital productivity in Turkey

Cited by 15 publications

References 28 publications

The effect of Iran’s health transformation plan on hospital performance: Kerman province

The effect of Iran’s health transformation plan on hospital performance: Kerman province

Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?

Examination of Efficiency Change of Provincial Hospitals in Azerbaijan with Malmquist Index

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