Stohastic Frontier Analysis in health units: A systematic review and Meta-Analysis

Abstract

Background In recent years, parametric and non-parametric methods, especially the SFA, have been used at an increasing rate to measure efficiency in the health sector in the cases of political systems transition or with emphasis on the impact on the economic crisis or other types of crises.The purpose is the literature review of efficiency studies using the Stohastic Frontier Analysis (SFA) with emphasis on inputs and outputs, so that the resulting knowledge can be used for further efficiency study using the SFA method. Methods The data used in the study were derived from literature review of efficiency studies using the SFA method in Pubmed, Scopus, Heal-Link and Google scholar databases. The study was designed to review literature efficiency studies conducted using the SFA method and to perform meta-analysis of the findings of these studies. The data were extracted and then the stated methodology of the research was applied following the PICOS model protocol.The meta-analysis of the data obtained from the literature overview was analyzed using the KNIME software. Results Efficiency studies with SFA show great heterogeneity due to the different models used in them and the different areas in which they are performed. Most frequently found inputs and outputs in the reviewed studies were identified.Using KNIME software,the dominance of the classic SFA models in theefficiency assessment was shownand the overwhelming superiority of using SFA to measure Technical Efficiencywas shown also. Proposals for policy interventions are heterogeneous and can be classified into different levels of policy interventions. Conclusions The main inputs – outputs used in the efficiency studies with SFA were identified. Efficiency is basically high. The proposals for political interventions are classified at political, managerial and operational levels.