Abstract
This study measures and compares efficiency of Council Designated Hospitals (CDHs) and Volunteering Agency Hospitals (VAHs) in Tanzania. The study employs 34 hospitals in Data Envelopment Analysis (DEA) from 2009 to 2013. Mann Whitney U was adopted to test the null hypothesis that means distribution is equal across the CDHs and VAHs. Output variables used were inpatients days, admissions, outpatients visit, total birth, and minor surgical operation, while the hospitals' beds and full-time equivalents (FTEs) were adopted as hospitals' inputs. Findings revealed that mean variable return to scale (VRTS) technical efficiency for CDHs was 0.744%, only 9 CDHs were found to be technically efficient and 6 were experiencing scale efficiency. However, most of CDHs hospitals were operating close to the scale efficiency as they have mean scale efficiency of 0.88823%. VAHs hospitals had mean VRTS technical efficiency of 0.702% and 7 hospitals were found to be scale efficient. Since the p-value is less than the 5% we rejected the null hypothesis that Mean distribution of technical efficiency score is equal across the CDHs and VAHs hospitals. The study recommends that hospitals experiencing a decreasing return to scale (DRS) or diseconomies of scale their size should be revisited to make them efficient. Hospitals sharing economies of scale should be equally supplied with health resources to increase their activities. This study suggests that the extension of this work should focus on how inefficient hospitals could improve their performance, given the available scarce resources.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Aday, L.A.: Evaluating the Healthcare System: Effectiveness, Efficiency, and Equity. Health Administration press, Chicago (2004)
Afriat, S.N.: Efficiency estimation of production functions. Int. Econ. Rev. 13(3), 568 (1972)
Ancarani, A., Di Mauro, C., Giammanco, M.D.: The impact of managerial and organizational aspects on hospital wards’ efficiency: Evidence from a case study. Eur. J. Oper. Res. 194(1), 280–293 (2009)
Banker, R.D., Charnes, A., Cooper, W.W.: Some models for estimating technical and scale inefficiencies in data envelopment analysis. Manag. Sci. 30(9), 1078–1092 (1984)
Biørn, E., Hagen, T.P., Iversen, T., Magnussen, J.: The effect of activity-based financing on hospital efficiency: a panel data analysis of DEA efficiency scores 1992–2000. Health Care Manag. Sci. 6(4), 271–283 (2003)
Boles, J.N.: Efficiency squared--efficient computation of efficiency indexes. In: Proceedings of the Annual Meeting (Western Farm Economics Association), vol. 39, pp. 137–142. Western Agricultural Economics Association (1966)
Bwana, K.M.: Evaluating the productivity of faith based hospitals in tanzania: application of malmquist productivity index (MPI) approach. Int. J. Finan. Econ. 3(4), 207–216 (2014)
Bwana, K.M.: Investigating efficiency based on the hospitals size: an application of a non-parametric approach to the private hospitals in Tanzania: African. J. Appl. Res. 4(1), 106–119 (2018a)
Bwana, K.M.: Evaluating financial strength of council designated hospitals (CDHs) in Tanzania using financial strength index (FSI) model. Afr. J. Appl. Res. 4(2), 32–44 (2018b)
Bwana, K.M.: Impact of Public Private Partnerships (PPPs) financial performance of Council Designated Hospitals (CDHs) in Tanzania. Afr. J. Appl. Res. 4(1), 120–129 (2018c)
Charnes, A., Cooper, W., Rhodes, E.: Measuring the efficiency of decision making units. Eur. J. Oper. Res. 2(6), 429–444 (1978)
Coyne, J.S., Richards, M.T., Short, R., Schultz, K., Singh, S.G.: Hospital cost and efficiency: do hospital size and ownership type really matter? J. Healthcare Manag. 54(3), 163–176 (2009)
Cummins, J.D., Zi, H.: Comparison of frontier efficiency methods: an application to the US life insurance industry. J. Prod. Anal. 10(2), 131–152 (1998)
Farrell, M.J.: The measurement of productive efficiency. J. Roy. Stat. Soc. Ser. Gen. 120(3), 253–290 (1957)
Gerdtham, U.G., Rehberg, C., Tambour, M.: The impact of internal market on health care efficiency. evidence from the health care reforms in Sweden. Appl. Econ. 31, 935–945 (1999)
Hollingsworth, B.: The measurement of efficiency and productivity of health care delivery. Health Econ. 17(10), 1107–1128 (2008)
Hu, J.L., Huang, Y.F.: Technical efficiencies in large hospitals: a managerial perspective. Int. J. Manag. 21(4), 506–513 (2004)
Jehu-Appiah, C., Sekidde, S., Adjuik, M., Akazili, J., Almeida, S., Nyonator, F., Baltussen, R., Asbu, E., Kirigia, J.: Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis. Cost Effect. Resour. Allocation 12(1), 9 (2014). https://doi.org/10.1186/1478-7547-12-9
Kontodimopontos, N., Nanos, P., Niakas, D.: Balancing efficiency of health services and equity of access in remote areas in Greece. Health Policy 76, 49–57 (2006)
Moshiri, H., Aljunid, S., Amin, R.M., Dahlui, M., Ibrahim, W.N.: Measuring efficiency of teaching hospitals in Malaysia. Int. J. Bus. Manag. 6(4), 207–213 (2011)
Nedelea, J.: Impact of Conversion to Critical Access Hospital Status on Hospital Efficiency: A PhD Thesis. Louisiana State University, USA (2012)
Ozcan, Y.A.: Sensitivity analysis of hospitals efficiency under alternative output/input and peer groups: a reviewer. Knowl. Politics 5, 1–29 (1992)
Ozcan, Y.A.: Healthcare Benchmarking and Performance Evaluation: An Assessment of DEA. Springer, Norwell (2008)
Parking, D., Hollingsworth, B.: Measuring production efficiency of acute hospitals in Scotland, 1991–4: validity issues in data envelopment analysis. Appl. Econ. 29, 1425–1433 (1997)
Rosko, M.: Measuring technical efficiency in health organization. J. Med. Syst. 14(5), 307–322 (1990)
Rosko, M.D., Mutter, R.: Inefficiency Differences between the critical access hospitals and prospectively paid rural hospitals. J. Health Politics Policy Laws 35(1), 95–126 (2010)
Semritc, A.V.: Indicators of Financial and Health Systems: A Systematic Review of the Literatures, Washington State University: Masters of Health Policy and Administration, Published Dissertation (2009)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Appendix 1: Variables Used in the Previous Similar Studies
Appendix 1: Variables Used in the Previous Similar Studies
Previous authors | Country | Applicability in previous studies |
|---|---|---|
NG (2008) | China | Measure of productive efficiency of health care sector in China (hospitals beds and number of staff were used as inputs variables) |
Barbara et al. (2009) | USA | Measuring technical efficiency in acute care units (hospitals beds and number of staff were used as inputs variables) |
Gannon (2005) | Ireland | Measuring technical efficiency of hospitals in Ireland (hospitals beds and number of staff were used as inputs variables) |
Harris et al. (2000) | USA | Impact of mergers on the hospitals efficiency performance. (total number of staff was used as the inputs variables) |
Nedelea (2012) | USA | Measuring the impact of hospitals status conversion on hospitals efficiency (hospitals beds and number of staff were used as inputs variables while outpatient surgery and total birth was used as output variables) |
Barbara et al. (2009) | USA | Measuring technical efficiency in acute care units (hospitals beds was used as inputs variables) |
Park et al. (2011) | USA | Measuring hospitals operating efficiency (total admission was used as outputs variables) |
Moshiri et al. (2011) | Malaysia | Measuring efficiency of teaching hospitals (total admission was used as outputs variables) |
Rosko and Mutter (2010) | USA | Inefficiency difference between two groups of of systems (CAH and PPS) (total admission and outpatient surgery were used as outputs variables) |
Yawe (2006) | Uganda | Measuring productivity growth of district referral hospitals in Uganda (total birth was used as output variable) |
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Bwana, K.M. (2021). Modeling Efficiency in the Presence of Volunteering Agency Hospitals and Council Designated Hospitals in Tanzania: An Application of Non Parametric Approach. In: Mojekwu, J.N., Thwala, W., Aigbavboa, C., Atepor, L., Sackey, S. (eds) Sustainable Education and Development. Springer, Cham. https://doi.org/10.1007/978-3-030-68836-3_16
Download citation
DOI: https://doi.org/10.1007/978-3-030-68836-3_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-68835-6
Online ISBN: 978-3-030-68836-3
eBook Packages: EngineeringEngineering (R0)