Measuring hospital efficiency in Belize: a data envelopment analysis approach

Abstract

Abstract Title: Measuring Hospital Efficiency in Belize: A Data Envelopment Analysis Approach Author: Lily Jamini Guerra Advisor: Yi-Hsin Elsa Hsu Ph.D., Associate Professor Providing efficient health care has become the primary focus within health systems therefore prompting health officials or authorities to develop health reforms. The Government of Belize (GOB), the financial mediator of health care in Belize, presented its New Health Care Reform in 2001. This entailed a decentralized system with the establishment of 4 health regions headed by a Regional Health Manager who possesses managerial autonomy. Up to date, no sort of evaluation has been conducted to assess the performance of these public facilities. Hence, this study aims to evaluate the 7 public hospitals in Belize from 2001-2008, evaluates any performance variations among the 4 regional management system within this period and proposes new approaches for controlling costs and improving quality to health managers, policy makers, and respective governmental bodies. Data Envelopment Analysis (DEA), a non-parametric linear programming model, was used to measure the technical efficiencies (TE) of these 7 public hospitals for a 8-year period (2001-2008). The results yield a mean TE of 0.89, which means that more outputs could be produced with the present levels of inputs of hospitals. Descriptive statistics demonstrated an overall increase in both input and output variables within the 8-year study period. Increments include: 2% (BEDS), 23% (NS), 42% (PHYS), 237% (EXPEN), 7% (OUTPAT), and 18% (INPAT). A Kruskal-Wallis Test was computed to certify any equality of population among median of the two independent groups, years and hospitals. The hospitals group yielded a P-value of 0.001 indicating a statistical significance. Summarily, this study provides the first baseline mechanism pertaining to technical efficiency information which could be used by the respective governmental authorities in monitoring future efficiency performances. Policy makers could assist future researchers by modifying the indicators for the data collection process within hospital, regional, and ministerial levels for obtaining more concise datasets. In addition, this study can assist policy makers in identifying the medical resources' deployment policies by establishing a priority setting mechanism which would intermittently provide information on the needs of the hospitals. Acknowledgement of this study will undoubtedly enable the respective authorities within the Ministry of Health in offering efficient, equitable, and quality health services to all the people of Belize.