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Technical efficiency of public hospitals in Togo: A directional distance function approach

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  • Esso-hanam Atake

    (University of Lome)

Abstract

Estimates indicate that 16% of the population applied for the service of doctors in 2011 in Togo. From 2008 to 2012, it was noted an average increase of patient deaths by 10%. The present study is aimed at looking at the issue of efficiency of public hospitals in Togo. We used the directional distance functions to analyze the technical efficiency of 139 public hospitals in Togo. The data were extracted from the annual reports of health activities of each hospital. These data were supplemented by visits and interviews with hospital officials. On average, 60.71% of large size public hospitals are technically inefficient. In these hospitals, only 41.45% of the beds were occupied in 2010. Furthermore, on average, 48.83% and 63.47% of paramedical and administrative staffs were actually employed in these hospitals. Nevertheless, outputs could be increased by 94.24% while maintaining inputs levels in Pediatrics services. The removal of the evaluation of agents funded from the autonomous budget and the lack of department heads in many health centers contribute to the increase of the technical inefficiency. The lack of qualified personnel and technical equipment, the dilapidated health infrastructures and the low financial affordability may explain these inefficiencies. The governance factors such as the effective management of human and technical resources should occupy a prominent place in the health development policies.

Suggested Citation

  • Esso-hanam Atake, 2015. "Technical efficiency of public hospitals in Togo: A directional distance function approach," Economics Bulletin, AccessEcon, vol. 35(3), pages 1752-1764.
    • Handle: RePEc:ebl:ecbull:eb-15-00163
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    References listed on IDEAS

    as
    1. Luenberger, David G., 1992. "Benefit functions and duality," Journal of Mathematical Economics, Elsevier, vol. 21(5), pages 461-481.
    2. Barros, Carlos Pestana & Menezes, Antonio & Vieira, José António Cabral & Peypoch, Nicolas & Solonandrasana, Bernardin, 2007. "An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator," IZA Discussion Papers 2689, Institute of Labor Economics (IZA).
    3. George W. Wilson & Joseph M. Jadlow, 1982. "Competition, Profit Incentives, and Technical Efficiency in the Provision of Nuclear Medicine Services," Bell Journal of Economics, The RAND Corporation, vol. 13(2), pages 472-482, Autumn.
    4. Tim Coelli & Antonio Estache & Sergio Perelman & Lourdes Trujillo, 2003. "A Primer on Efficiency Measurement for Utilities and Transport Regulators," World Bank Publications - Books, The World Bank Group, number 15149, December.
    5. Luenberger, David G, 1996. "Welfare from a Benefit Viewpoint," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 7(3), pages 445-462, April.
    6. Banker, Rajiv D & Maindiratta, Ajay, 1988. "Nonparametric Analysis of Technical and Allocative Efficiencies in Production," Econometrica, Econometric Society, vol. 56(6), pages 1315-1332, November.
    7. Sherman T. Folland & Richard A. Hofler, 2001. "How reliable are hospital efficiency estimates? Exploiting the dual to homothetic production," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 683-698, December.
    8. Carlos Barros & António Gomes de Menezes & Nicolas Peypoch & Bernardin Solonandrasana & José Vieira, 2008. "An analysis of hospital efficiency and productivity growth using the Luenberger indicator," Health Care Management Science, Springer, vol. 11(4), pages 373-381, December.
    9. Sara Moreira, 2008. "Efficiency Analysis of Public Hospitals Transformed into Public Corporations: An Application of Data Envelopment Analysis," Economic Bulletin and Financial Stability Report Articles and Banco de Portugal Economic Studies, Banco de Portugal, Economics and Research Department.
    10. David G. Luenberger, 1996. "Welfare from a benefit viewpoint (*)," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 7(3), pages 445-462.
    11. Varian, Hal R, 1984. "The Nonparametric Approach to Production Analysis," Econometrica, Econometric Society, vol. 52(3), pages 579-597, May.
    12. Afonso, António & Fernandes, Sónia, 2008. "Assessing and explaining the relative efficiency of local government," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 37(5), pages 1946-1979, October.
    13. L. Steinmann & P. Zweifel, 2003. "On the (in)efficiency of Swiss hospitals," Applied Economics, Taylor & Francis Journals, vol. 35(3), pages 361-370.
    14. Miika Linna, 1998. "Measuring hospital cost efficiency with panel data models," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 415-427, August.
    15. Rolf Färe & Shawna Grosskopf, 2000. "Theory and Application of Directional Distance Functions," Journal of Productivity Analysis, Springer, vol. 13(2), pages 93-103, March.
    16. Fare, Rolf & Knox Lovell, C. A., 1978. "Measuring the technical efficiency of production," Journal of Economic Theory, Elsevier, vol. 19(1), pages 150-162, October.
    17. Martine Audibert & Yohana Dukhan & Jacky Mathonnat & Ningshan Chen & Aning Ma & Aïtian Yin, 2008. "Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong," Revue d’économie du développement, De Boeck Université, vol. 16(1), pages 63-100.
    18. Chambers, Robert G. & Chung, Yangho & Fare, Rolf, 1996. "Benefit and Distance Functions," Journal of Economic Theory, Elsevier, vol. 70(2), pages 407-419, August.
    19. Peter Bogetoft & Lars Otto, 2011. "Benchmarking with DEA, SFA, and R," International Series in Operations Research and Management Science, Springer, number 978-1-4419-7961-2, December.
    20. Vita, Michael G., 1990. "Exploring hospital production relationships with flexible functional forms," Journal of Health Economics, Elsevier, vol. 9(1), pages 1-21, June.
    21. Martine Audibert & Jacky Mathonnat & Yohana Dukhan & Ningshan Chen & Aning Ma & Aïtian Yin, 2008. "Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong," Post-Print hal-00276226, HAL.
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    1. Wirat Krasachat & Suthathip Yaisawarng, 2021. "Directional Distance Function Technical Efficiency of Chili Production in Thailand," Sustainability, MDPI, vol. 13(2), pages 1-18, January.

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    More about this item

    Keywords

    efficiency; public hospital; qualified personnel; governance; directional distance function; R software;
    All these keywords.

    JEL classification:

    • D2 - Microeconomics - - Production and Organizations
    • I1 - Health, Education, and Welfare - - Health

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