IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v34y2019i4pe1417-e1436.html
   My bibliography  Save this article

A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Author

Listed:
  • Edson Serván‐Mori
  • Miguel Ángel Mendoza
  • Carlos Chivardi
  • Carlos Pineda‐Antúnez
  • Roxana Rodríguez‐Franco
  • Gustavo Nigenda

Abstract

Objective To analyze the formation of spatial clusters of technical efficiency (TE) in the production of outpatient maternal health services in México for the period 2008 to 2015. Methods We performed a longitudinal analysis of administrative and structural data related to the 243 Mexican health jurisdictions. We use window data envelopment analysis and spatial and econometric techniques. Structural correlates of each TE cluster obtained were identified estimating a pooled multinomial logit model. Results We observed an increase in the overall TE, accompanied by a reduction in its standard deviation. Furthermore, we identified positive TE spatial dependence both globally and locally. Multiple regression analysis showed that the maximum‐performance TE cluster was composed of health jurisdictions located in the North of México and characterized by social marginalization, a reduced indigenous population, and a low demand for maternal health services. Conclusions The identification of TE clusters can provide elements to induce decision makers to innovative in ways of allocating resources and manage their utilization. In México as other low‐ and middle‐income countries, it is key to develop targeting strategies to implement specific health services innovations putting to the population to be served at the front of the strategy. This implies testing new modalities to strengthen primary health services, the empowerment of community participation, the training and allocation of health personnel that could respond adequately to population's demand, and the active involvement of competent state and local authorities in the assessment of the results of these innovations.

Suggested Citation

  • Edson Serván‐Mori & Miguel Ángel Mendoza & Carlos Chivardi & Carlos Pineda‐Antúnez & Roxana Rodríguez‐Franco & Gustavo Nigenda, 2019. "A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1417-1436, October.
    • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:4:p:e1417-e1436
    DOI: 10.1002/hpm.2785
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.2785
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hpm.2785?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
    2. Mary B Adam & Maria Dillmann & Mei-kuang Chen & Simon Mbugua & Joram Ndung’u & Priscilla Mumbi & Eunice Waweru & Peter Meissner, 2014. "Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-8, August.
    3. Edson Servan-Mori & Leticia Avila-Burgos & Gustavo Nigenda & Rafael Lozano, 2016. "A Performance Analysis of Public Expenditure on Maternal Health in Mexico," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-14, April.
    4. Ruggiero, John, 2000. "Measuring technical efficiency," European Journal of Operational Research, Elsevier, vol. 121(1), pages 138-150, February.
    5. Herwartz, Helmut & Schley, Katharina, 2018. "Improving health care service provision by adapting to regional diversity: An efficiency analysis for the case of Germany," Health Policy, Elsevier, vol. 122(3), pages 293-300.
    6. Patrícia Varela & Gilberto de Martins & Luiz Fávero, 2010. "Production efficiency and financing of public health: an analysis of small municipalities in the state of São Paulo — Brazil," Health Care Management Science, Springer, vol. 13(2), pages 112-123, June.
    7. Anselmi, Laura & Lagarde, Mylène & Hanson, Kara, 2018. "The efficiency of the local health systems: investigating the roles of health administrations and health care providers," Health Economics, Policy and Law, Cambridge University Press, vol. 13(1), pages 10-32, January.
    8. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    9. Angeliki Flokou & Vassilis Aletras & Dimitris Niakas, 2017. "A window-DEA based efficiency evaluation of the public hospital sector in Greece during the 5-year economic crisis," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-26, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Edson Serván-Mori & Carlos Chivardi & Fato Fene & Ileana Heredia-Pi & Miguel Ángel Mendoza & Gustavo Nigenda, 2020. "Tackling maternal mortality by improving technical efficiency in the production of primary health services: longitudinal evidence from the Mexican case," Health Care Management Science, Springer, vol. 23(4), pages 571-584, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Edson Serván-Mori & Carlos Chivardi & Fato Fene & Ileana Heredia-Pi & Miguel Ángel Mendoza & Gustavo Nigenda, 2020. "Tackling maternal mortality by improving technical efficiency in the production of primary health services: longitudinal evidence from the Mexican case," Health Care Management Science, Springer, vol. 23(4), pages 571-584, December.
    2. Pourmahmoud, Jafar & Bagheri, Narges, 2023. "Uncertain Malmquist productivity index: An application to evaluate healthcare systems during COVID-19 pandemic," Socio-Economic Planning Sciences, Elsevier, vol. 87(PA).
    3. Girma Jirata Duguma & Jiqin Han, 2021. "Effect of deposit mobilization on the technical efficiency of rural saving and credit cooperatives: Evidence from Ethiopia," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 92(4), pages 621-647, December.
    4. Juliane Sormain & Michael Ryan, 2023. "Regional healthcare infrastructure disparities and foreign direct investment into Europe," Economics and Business Letters, Oviedo University Press, vol. 12(1), pages 49-61.
    5. Katharina Schley, 2018. "Health care service provision in Europe and regional diversity: a stochastic metafrontier approach," Health Economics Review, Springer, vol. 8(1), pages 1-11, December.
    6. Ruggiero, John, 2004. "Performance evaluation when non-discretionary factors correlate with technical efficiency," European Journal of Operational Research, Elsevier, vol. 159(1), pages 250-257, November.
    7. Davide Luca & Felix Modrego, 2021. "Stronger together? Assessing the causal effect of inter‐municipal cooperation on the efficiency of small Italian municipalities," Journal of Regional Science, Wiley Blackwell, vol. 61(1), pages 261-293, January.
    8. Fazıl Gökgöz & Fatma Demir, 2014. "An Efficiency Analysis For The European Telecommunication Sector," Economy & Business Journal, International Scientific Publications, Bulgaria, vol. 8(1), pages 141-158.
    9. Aleksandar Medarević & Dejana Vuković, 2021. "Efficiency and Productivity of Public Hospitals in Serbia Using DEA-Malmquist Model and Tobit Regression Model, 2015–2019," IJERPH, MDPI, vol. 18(23), pages 1-22, November.
    10. Iyad Dhaoui, 2019. "Healthcare system efficiency and its determinants: A two-stage Data Envelopment Analysis (DEA) from MENA countries," Working Papers 1320, Economic Research Forum, revised 21 Aug 2019.
    11. Pejman Peykani & Jafar Gheidar-Kheljani & Reza Farzipoor Saen & Emran Mohammadi, 2022. "Generalized robust window data envelopment analysis approach for dynamic performance measurement under uncertain panel data," Operational Research, Springer, vol. 22(5), pages 5529-5567, November.
    12. Simpson, N.C. & Tacheva, Zhasmina & Kao, Ta-Wei, 2023. "Semi-directedness: New network concepts for supply chain research," International Journal of Production Economics, Elsevier, vol. 256(C).
    13. Wen-Min Lu & Qian Long Kweh & Chung-Wei Wang, 2021. "Integration and application of rough sets and data envelopment analysis for assessments of the investment trusts industry," Annals of Operations Research, Springer, vol. 296(1), pages 163-194, January.
    14. Franz R. Hahn, 2007. "Determinants of Bank Efficiency in Europe. Assessing Bank Performance Across Markets," WIFO Studies, WIFO, number 31499, April.
    15. Alperovych, Yan & Hübner, Georges & Lobet, Fabrice, 2015. "How does governmental versus private venture capital backing affect a firm's efficiency? Evidence from Belgium," Journal of Business Venturing, Elsevier, vol. 30(4), pages 508-525.
    16. Wang, Zhao-Hua & Zeng, Hua-Lin & Wei, Yi-Ming & Zhang, Yi-Xiang, 2012. "Regional total factor energy efficiency: An empirical analysis of industrial sector in China," Applied Energy, Elsevier, vol. 97(C), pages 115-123.
    17. Ruiqing Yuan & Xiangyang Xu & Yanli Wang & Jiayi Lu & Ying Long, 2024. "Evaluating Carbon-Emission Efficiency in China’s Construction Industry: An SBM-Model Analysis of Interprovincial Building Heating," Sustainability, MDPI, vol. 16(6), pages 1-16, March.
    18. Azarnoosh Kafi & Behrouz Daneshian & Mohsen Rostamy-Malkhalifeh, 2021. "Forecasting the confidence interval of efficiency in fuzzy DEA," Operations Research and Decisions, Wroclaw University of Science and Technology, Faculty of Management, vol. 31(1), pages 41-59.
    19. Costa, Marcelo Azevedo & Lopes, Ana Lúcia Miranda & de Pinho Matos, Giordano Bruno Braz, 2015. "Statistical evaluation of Data Envelopment Analysis versus COLS Cobb–Douglas benchmarking models for the 2011 Brazilian tariff revision," Socio-Economic Planning Sciences, Elsevier, vol. 49(C), pages 47-60.
    20. Gilligan, Daniel O., 1998. "Farm Size, Productivity, And Economic Efficiency: Accounting For Differences In Efficiency Of Farms By Size In Honduras," 1998 Annual meeting, August 2-5, Salt Lake City, UT 20918, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:34:y:2019:i:4:p:e1417-e1436. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.