مقاله انگلیسی کارایی و عوامل مدیریتی: یافتن تعادل در مراکز مراقبت تالاسمی
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Abstract
Background: Optimizing efficiency has become increasingly critical with the growing demand for finite healthcare resources driven by population growth and an ageing society. Hence, policymakers are urgently finding more efficient ways to deliver health services. Thalassemia is a complex inherited blood disorder with significant prevalence in Malaysia. The high number of patients put substantial strain on the healthcare system. This study aims to evaluate the technical efficiency of thalassaemia care centres throughout Malaysia and the determinants that affect the efficiency. Method: Data from 30 public hospitals with thalassaemia care centres were collected. A double bootstrap data envelopment analysis (DEA) approach is used with the assumption of input-oriented and variable-to-scale DEA models to generate technical efficiency scores. Bootstrap truncated regression was later conducted to identify the factors affecting the efficiency scores. Results: The mean bias-corrected technical efficiency score has improved to 0.75 in 2017 from 0.71 in 2016. In both years, more than 50% of thalassaemia care centres showed good efficiency scores (0.8-1.0). Management factors that affect the efficiency scores include separation of patient management (β = 0.0653) and budget (β = 0.0843), where they are found to positively affect the efficiency scores. In contrast, having longer operating hours is found to inversely influence the performance levels (β = − 0.4023). Conclusions: The study provides a pioneering framework to evaluate the technical efficiency of thalassaemia treatment centres in public healthcare settings and could provide a useful guide for policymaker and thalassaemia care centre managers to improve efficiency in service delivery to thalassaemia patients and their caregivers without compromising quality of care.
Background
Healthcare is a significant component of country expenditures. Across the Organization for Economic Cooperation Development (OECD) countries, health spending accounts for almost 10% of a country’s gross domestic product (GDP) (1). Optimizing efficiency has become increasingly critical with the growing demand for finite healthcare resources driven by population growth and an ageing society. Hence, policymakers are urgently finding more efficient ways to deliver health services. Efficiency improvements in healthcare delivery, even in small amounts, can yield considerable savings on resources, which then promotes further expansion of services for the community. Efficiency in healthcare is an attribute of performance that is measured by examining the relationship between specific products of the healthcare system and the resources used to create those products (2, 3). A provider is said to be efficient if the input could be minimized to produce a set of given outputs or conversely able to maximize the output for a given set of inputs.