142nd APHA Annual Meeting and Exposition

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Measuring provincial hospitals' efficiency in Afghanistan to help the Ministry of Public Health achieve efficiency with a limited budget

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Mohammad Nowroz Haqmal, MD, MSc, MPH , Afghanistan Ministry of Public Health, Afghanistan Ministry of Public Health, Kabul, Afghanistan
Background: Afghanistan is a donor dependent country with 60% of the health budget spent on curative care. Measuring provincial hospital efficiency is crucial for becoming efficient within a limited budget.

Objective:To measure technical and scale efficiency of provincials’ hospitals in Afghanistan, and assess influence of potential environmental factors on technical efficiency.

Methods:Data was obtained from National Health Management Information System (NHIMS) database of Afghanistan Ministry of Public Health for 24 provincial hospitals covering 7 years (2006-2012).Data Envelopment Analysis (DEA) was used for measuring hospitals efficiency and Tobit Regression was conducted to assess the effect of environmental factors on efficiency.

Results:The DEA model showed that only two (8.33%) of the 24 provincial hospitals were constantly technically and scale efficient. The annual number of technical and scale efficient hospitals varied; for instance, the lowest number was 6 in 2010 and the highest number was observed as 10 in 2008.

The mean technical efficiency score was 0.831 ,the mean hospital pure technical efficiency was 90% , and the mean scale efficiency was 90.8% across the study period.

The Tobit regression demonstrated that hospital technical efficiency was not associated with environmental factors such as location, and implementing agency.

Conclusion: The majority of the provincial hospitals were technical and scale inefficient. To improve scale efficiency the Afghanistan ministry of public health should either down size the scale inefficient hospitals or upgrade them considering their Return to Scale (RTS). Similarly, to improve technical efficiency the ministry has to reduce the resources.

Learning Areas:

Administration, management, leadership
Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related research

Learning Objectives:
Assess provincial hospitals efficiency in donor- dependent Afghanistan to become efficient within a limited budget

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted this research as part of my dissertation for MSc in Global Health and Development degree at the University College London and I have used the Afghanistan Ministry of Public Health data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.