TAILIEUCHUNG - Marschall and Flessa Health Economics Review 2011, 1:5

Marschall and Flessa Health Economics Review 2011, 1:5 RESEARCH Open Access Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis Paul Marschall* and Steffen Flessa Abstract Background: Providing health care services in Africa is hampered by severe scarcity of personnel, medical supplies and financial funds. Consequently, managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However, very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context. Objective: This study determines. | Marschall and Flessa Health Economics Review 2011 1 5 http content 1 1 5 o Health Economics Review a SpringerOpen Journal RESEARCH Open Access Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis Paul Marschall and Steffen Flessa Abstract Background Providing health care services in Africa is hampered by severe scarcity of personnel medical supplies and financial funds. Consequently managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context. Objective This study determines the relative efficiency of primary care facilities in Nouna a rural health district in Burkina Faso. Furthermore it analyses the factors influencing the efficiency of these institutions. Methodology We apply a two-stage Data Envelopment Analysis DEA based on data from a comprehensive provider and household information system. In the first stage the relative efficiency of each institution is calculated by a traditional DEA model. In the second stage we identify the reasons for being inefficient by regression technique. Results The DEA projections suggest that inefficiency is mainly a result of poor utilization of health care facilities as they were either too big or the demand was too low. Regression results showed that distance is an important factor influencing the efficiency of a health care institution Conclusions Compared to the findings of existing one-stage DEA analyses of health facilities in Africa the share of relatively efficient units is slightly higher. The difference might be explained by a rather homogenous structure of the primary care facilities in the Burkina Faso sample. The study also indicates that improving the accessibility of primary care .

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