Abstract
BackgroundAmid the rising demand for healthcare services in Saudi Arabia, there is a need to monitor, evaluate, and improve performance in the delivery of these services. In this regard, the aim of this study was to estimate changes in total factor productivity (TFP) in healthcare services across the health system administrative regions in Saudi Arabia from 2006 to 2018. The contributions of changes in efficiency and technology to the observed changes in TFP were further evaluated.MethodsThe data used for this study were extracted from annual Ministry of Health Statistical Yearbooks for the period of 2006–2018. TFP changes were estimated using the Malmquist Productivity Index, in which technology frontiers were constructed through data envelopment analysis. The changes in TFP were decomposed into changes in technology, changes in pure technical efficiency, and changes in scale efficiency following the Färe-Grosskopf-Norris-Zhang method. As robustness checks, we used bootstrapping to construct intervals and applied alternative decomposition methods. The changes in TFP and its sources were also compared between public and private hospitals.ResultsOver the period from 2006 to 2018, TFP for healthcare services has decreased on average by 5.6% per year solely on account of a technical regress. Public hospitals registered a higher deterioration in productivity (6.0% per year) than private hospitals (4.8% per year).ConclusionUsing the available resources, there is potential for realising gains in productivity of healthcare services by addressing existing technological challenges. Since the decline in TFP is entirely a problem of technical regress, the primary solution should focus on strategies for achieving technical progress (innovation) through investment in more or better machinery, equipment, and structures for healthcare service provision.
Highlights
There is an ever-increasing demand for healthcare services in the Kingdom of Saudi Arabia (KSA) due to a variety of factors, including a growing population, increased life expectancy, proliferation of lifestyle-related
In this study, we estimated changes in total factor productivity (TFP) in health services that have occurred in the KSA over time between 2006 and 2018 across the healthcare system administrative regions, and further evaluated the contribution of the various components to those changes
The results revealed that productivity of the healthcare system in the KSA has decreased by an average of 5.6% during this period
Summary
There is an ever-increasing demand for healthcare services in the Kingdom of Saudi Arabia (KSA) due to a variety of factors, including a growing population, increased life expectancy, proliferation of lifestyle-relatedAl‐Hanawi and Makuta Cost Effectiveness and Resource Allocation (2022) 20:3In order to monitor, evaluate, and improve performance in the delivery of healthcare services, it is necessary to measure such performance, track its evolution over time, and identify the sources of these changes. In the KSA, almost all studies conducted to date on performance of the health sector have focused on measuring and/or comparing efficiency, demonstrating widespread inefficiencies among public hospitals [8, 9]. These studies established that there has been little improvement in efficiency over time [10]. Amid the rising demand for healthcare services in Saudi Arabia, there is a need to monitor, evalu‐ ate, and improve performance in the delivery of these services In this regard, the aim of this study was to estimate changes in total factor productivity (TFP) in healthcare services across the health system administrative regions in Saudi Arabia from 2006 to 2018. The contributions of changes in efficiency and technology to the observed changes in TFP were further evaluated
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