Measuring the Efficiency of Chilean Primary Healthcare Centres

Abstract

This paper examines whether different approaches for estimating the technical efficiency of a primary healthcare centre-PHC-can have significantly different results. Although effective regulation demands the development of measures for establishing good operation levels, few studies have compared results from a data envelopment analysis-DEA-and stochastic frontier analysis-SFAin a PHC. Furthermore, to the best of our knowledge, no studies have used Chilean nationwide data. Efficiency refers to the relation between the number of output units per input unit. Effectiveness evaluates the outcome of medical care and can be influenced by efficiency. The data that were used in this study came from 259 Chilean municipalities. We included two outputs-medical and checkup visits-and three inputs-staff, general service and drugs expenses. For the DEA, we used a variable return to scale output-oriented model. Before applying the SFA, a principal component analysis-PCA-combined the two outputs. The results were similar for both methods: the SFA efficiency averages were 70.89% and 65.83% and the DEA averages were 68.37% and 54.46% for the urban and rural municipalities, respectively. In addition to defining a frontier of "best practice", this study merged the PCA with the SFA to form an innovative approach to combining outputs.

Avaliação da eficiência das ações de controle da hipertensão arterial sistêmica na Atenção Básica: um estudo da Região Norte do Brasil

“…Segundo Kontodimopoulos et al (2007), a localização dos centros de atenção primária (urbano ou rural) e o seu tamanho (pequeno, médio ou grande porte) foram os preditores significativos de eficiência técnica. Esta ótica encontra afinidade com os achados de Ramírez-Valdivia et al (2015), que analisaram 259 municípios chilenos e observaram que os municípios urbanos são, em média, mais eficientes (68,4%) do que os rurais (54,5%). Oikonomou et al (2016) avaliaram 42 centros de saúde da Grécia e verificaram que as unidades mais ineficientes estavam localizadas em áreas com menor porte populacional e que se situavam em áreas mais distantes.…”

Measuring Technical Efficiency of Hospitals Using Data Envelopment Analysis: A Review

“…The assumption under SFA is that all of the entities are not efficient and subject to random noise (Ramírez-Valdivia, Maturana, Mendoza-Alonzo, & Bustos, 2015). It considers as a common method to measure efficiency under the parametric-economic approach (Lordan, 2007).…”

“…Basically, SFA applies multivariate statistical techniques to examine output or cost disparity between firms and thus yield efficiency scores for the units under examination (Lordan, 2007). The SFA distinguish between random noise and inefficiency under the hypothesis of its two dissemination, which are symmetric and asymmetric (Ramírez-Valdivia et al, 2015).…”

“…The DEA has its capability to cope with complicated production environments with multiple input and output (Jacobs, 2001b;Ruggiero, 2007). In contrast, the parametric approach such as SFA only able to manage multiple inputs with one input (Hamidi, 2016;Ramírez-Valdivia et al, 2015). DEA does not require the input prices to estimate technical efficiency, while the parametric approaches are required the input prices (Grosskopf & Valdmanis, 1993).…”

Avaliação da atenção primária à saúde no estado do Amazonas no período de 2010 a 2014: uma abordagem de múltiplos estágios

“…Já como desvantagens é possível relacionar que seus resultados são: altamente sensíveis a observações discrepantes (outliers), insensíveis ao ruído estatístico e a medição da eficiência comparativa baseia-se na suposição de que algumas DMUs devem ser perfeitamente eficientes (Ramírez-Valdivia et al, 2015).…”