Applications of Data Envelope Analysis Using Efficient or Inefficient Frontiers in Evaluating the Efficiency of Rural Healthcare Centers (Case Study: Langroud County)

Abstract

Objective: This study was conducted to examine the efficiency of rural healthcare centers (Health Houses) including output-oriented efficiency, input-oriented efficiency, optimistic efficiency, pessimistic efficiency and efficiency range in Langerud County in Guilan province. Method: This study is a descriptive-analytical one whose data is cross-sectional collected through field works in 2016 from 45 rural healthcare centers in Langerud County. The required data were obtained from available documents and statistics, and were analyzed using Windeap and GAMS software packages. In this paper, to evaluate the performance of rural healthcare centers from March 2015 to March 2016, two inputs and three outputs were determined. The input included the costs and the number of health workers, and the outputs included family health clients, outpatients, and the clients who needed wound dressings. Findings: The results showed that nine out of 45 rural healthcare centers, with an efficiency score of 1, have efficient performance. Rural healthcare centers in villages of Garask, Koru Roud Khaneh, and Malat are respectively the first three villages with the highest efficiency score. The study results showed that the average optimistic efficiency at output-oriented and input-oriented efficiencies are 1.645 and 0.688, respectively, and 15.5% of rural healthcare centers are pessimistically inefficient. Besides, 64% of the units are between the efficient and inefficient frontiers, and are not pessimistically inefficient; meanwhile, those units are not on pessimistic lines of efficiency which demonstrates indulgence in input consumption or a potential ability in increased offered services or decreased input consumption. According to the results, maximum optimistic efficiency is 3.87 and its minimum is one. Maximum pessimistic efficiency is one and its minimum is 0.29. Practical Implications: As the results show, it is suggested that efficient healthcare units be used as paragons and that assessing educational requirements of inefficient rural healthcare centers would provide useful information for planners and policy makers.