Technical Efficiency of Private Clinics Under Universal Coverage Scheme in Bangkok, Thailand

Abstract

This study aimed to measure technical efficiency of 88 private clinics under Universal Coverage Scheme (UC) in Bangkok in fiscal year 2017 and to identify the factors affecting their technical efficiency. The study was divided to two parts. The first part was measuring of technical efficiency with data envelopment analysis (DEA) and the second part was identifying the factors affecting efficiency with regression analysis using Tobit model. The result of DEA under a variable return to scale assumption showed that 84 private clinics under UC (95.45 percent of the target of study) were operating on pure technical efficiency frontier (VRSTE), the mean pure technical efficiency score was equal to 0.98. Furthermore, the results of regression analysis revealed that only health supporting staff ratio was significantly affecting on pure technical efficiency (TEVRS) of private clinics under Universal Coverage Scheme (UC) while other explanatory variables such as family medical physician ratio, nurse practitioner ratio, health promotion and disease prevention service ratio, the number of Universal Coverage Scheme (UC) members, type of clinics and location were insignificant. As a result of DEA; patterns of scale inefficiencies showed that in order to achieve appropriate scale of operation, private clinics under UC which operated increasing return to scale (IRS) should expand their scale of operation while private clinics under UC which operated decreasing return to scale (DRS) should reduce their scale of operation. Moreover, as a result of regression analysis, in order to increase in efficiency, it should increase in health supporting staff ratio.