Measuring Technical Efficiency of Central Hospitals in Zimbabwe: Application of Data Envelopment and Stochastic Frontier Analysis using Panel Data (2009-2014)

Abstract

Zimbabwe is lacking resources to advance the country’s health sector needs. The country is off-track the achievement of Millennium Development Goals that are health related in their totality. Central hospitals, the core of the hospital referral system, had been marred with congestion, and overburdened with patients. There had been therefore frequent calls, from the public, for the need to improve the delivery of service at public hospitals. Amidst fiscal constraints, efficient use of resources had been cited as the key, relevant and important aspect of improving the healthcare delivery system. This study was undertaken to determine the extent to which the country can improve health outcomes through efficiency improvement. Two efficiency measurement approaches were used to evaluate the efficiency levels of central hospitals in Zimbabwe using data set for the years 2009 to 2013; the two efficiency measurement approaches are the Data Envelopment Analysis and the Stochastic Frontier Analysis. On average hospitals were found to exhibit inefficiency levels of about 37-39%. The DEA calculated Malmquist indices indicated that total factor productivity improved by 2% between 2009 and 2014 largely driven by improvements in scale efficiency. The study proposed that hospital output can be improved by about 38% without increasing inputs. This will be achieved through improved hospital operating system, improved management of resources or close monitoring of human resources and adequate loss control systems.