Measuring the Efficiency of Public Hospitals in Kuwait: A Two-Stage Data Envelopment Analysis and a Qualitative Survey Study

Abstract

The recent drop in oil prices has challenged public sector financing in Kuwait. Technical and scale efficiency scores for fifteen public hospitals in Kuwait from 2010 to 2014 were estimated using a two-stage data envelopment analysis (DEA). Technical efficiency scores were regressed against institutional characteristics using Tobit regression to investigate the determinants of efficiency differences in hospitals. Semi-structured interviews were also carried out with fourteen public and private hospital managers to qualitatively explore their perceptions and experience about about factors affecting hospital efficiency. The mean technical efficiency score for all hospitals was 85.8%, an improvement of 2% since 2010. The mean pure technical efficiency score was 79.6%, improving from 75% in 2010 to 81.2% in 2014. The mean scale efficiency score was 91.8%, improving from 87.6% in 2010 to 94.2% in 2014. Only three hospitals were constantly technically and scale efficient. Tobit regression showed that hospital efficiency was significantly associated with the average length of patient stay. Hospitals with more than 400 beds were potentially more technically and scale efficient. The qualitative study revealed that external factors affecting efficiency commonly included implemention of legislative changes and decreasing bureaucracy, while internal factors included increasing bed capacity and improving qualifications and training of human resources. Most public hospitals in Kuwait were not technically and scale efficient, but improvements were observed. Potential factors that affected the efficiency of hospitals in Kuwait were identified. These findings are useful to decision-makers in Kuwait for developing strategies to improve public hospital efficiency.

Measuring operational efficiency of isolation hospitals during COVID-19 pandemic using data envelopment analysis: a case of Egypt

“…The results are consistent with previous studies (e.g., Habib and Shahwan, 2020;Top et al, 2020;William et al, 2020;Ilgun and Konca, 2019;Plasschaert, 2018;Al-Refaie et al, 2017;Wang et al, 2016). They suggested that managers and policymakers could be relying on the most important variables (beds and nurses) in making (Alsabah et al, 2020) whereas nurses have an insignificant effect on efficiency. Consistent with previous studies (e.g.…”

“…DEA has been extensively used by researchers and practitioners to evaluate hospital performance and in measuring the efficiency of various types of healthcare organizations including public hospitals (Alsabah et al, 2020;Ngobeni et al, 2020;Najadat et al, 2020;Kocisova et al, 2018;Almiman, 2018;Mitropoulos et al, 2015;Mogha et al, 2015;Najadat and Alsmadi, 2011;Akazili et al, 2008), university and research hospitals (Akkan et al, 2020;Ilgun and Knoca, 2019;Bahrami et al, 2018;Chowdhury and Zelenyuk, 2016) and private hospitals (Habib and Shahwan, 2020;Gandhi and Sharma, 2018;Mogha et al, 2012). Ngobeni et al (2020) measured the technical efficiency of public hospitals in nine provinces in South Africa based on CRS and VRS-DEA during the period 2017-2018.…”

“…Moreover, inefficient organizations are characterized by poor use of resources, and the number of inputs and outputs affects the values of results. Using the two-stage DEA methodology Alsabah et al (2020) measured the technical efficiency of public hospitals in Kuwait during the period 2010-2014. The results verified that the level of efficiency has improved by 2% since 2010.…”

Efficiency Comparison of Public and Private Hospitals before and after the COVID-19 Pandemic: The Case of Hubei, China

“…This calls into question how well private hospitals perform in comparison to public hospitals. Researchers have extensively employed DEA to analyze hospital performance and measure the e ciency of various types of healthcare organizations, including public hospitals [29][30][31][32][33][34] and private hospitals [35][36][37][38].…”

Evaluating Public Healthcare Productivity and Health System Efficiency in the State of Kuwait: A Two-Stage Data Envelopment Analysis of Government Hospital Performance

“…If we begin evaluating the effectiveness of the financing function or Kuwait's health financing policies, we can see that by 2019, the current health expenditure in Kuwait as a percent of GDP was 5.5 percent; that corresponds to a 7.77 percent increase from the previous year in 2018 and maintains the positive percent change consistently found through the years -except for the minor dip in 2017 that indicates a -1.64 percent reduction from 2016; nevertheless, as displayed in Table 1 and Figure 1 [4], [5], the overall trend of the line graph suggests consistent increase before 2015 but continues to climb again after 2015 with a positive percent change of almost 40 percent between 2015-2019. This study will provide the necessary research to establish a difference in cost-effectiveness and quality of services; furthermore, this paper can contribute to the data and our later understanding and knowledge of the economic issues arising from increased healthcare costs.…”