Abstract
In this paper, the overall efficiency of health centers in Greece is measured by applying the input-oriented model of Data Envelopment Analysis. In addition, four different models were subjected to the input-oriented Data Envelopment Analysis to investigate the contribution of each category of human resources to the efficiency results of the health centers. The bootstrap technique was performed to generate confidence intervals for the models. Data for 155 health centers in Greece were provided by the Ministry of Health. The health centers submitted in the analysis obtained an average efficiency value of 0.932. The average results of the partial models in terms of each input show that the efficiency values achieved by the health centers are mostly influenced by the number of physicians and the number of managers employed. The second factor influencing the efficiency values of the health centers are the number of nursing staff occupied in the health centers. Non-medical staff employed in the health centers had the least contribution to the efficiencies measured. This paper provides important information for the stakeholders and the Government of Greece so as to better allocate the personnel employed in primary health care according to the efficiencies attained by the health centers.
Highlights
In the last decade, the World Health Organization (WHO) has focused on a strategy to strengthen and integrate primary health care, considering its major contribution to the national health system of every country
Considering the results of the inefficiency rates calculated for each of the models in this study under the Variable Returns to Scale (VRS) assumption, the analysis shows that the model using the number of employed managers as input has the most efficient health centers (64 health centers), followed by the model using as input the number of employed physicians (39 efficient health centers)
This paper may contribute to improve the overall efficiency of health centers in Greece
Summary
The World Health Organization (WHO) has focused on a strategy to strengthen and integrate primary health care, considering its major contribution to the national health system of every country. As a result of the economic crisis and funding cuts to the National Health System in Greece during 2010–2018, health expenditures in 2017 were 1.8% lower than the average of OECD countries [3,4], highlighting the already existing inadequate primary health care system [5], which is struggling with problems in the distribution of health services, productivity, and administration [6–8]. A reform was introduced to strengthen the National Health System by creating an integrated primary health care system, which included the fragmentation of primary health care services and the introduction of a two-pillar primary health care system from 2017 to 2020 [9,10]. The first pillar included the creation of Local Health units (TOMY) and the
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