PERFORMANCE OF COUNCIL DESIGNATED HOSPITALS (CDHS) IN TANZANIA: DOES EXPERIENCE MATTER?

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Kembo M. Bwana (PhD)

Abstract

This study attempts to shed light on the performance of CDHs based on experience. It examined efficiency and total factor productivity of 17 CDHs from 2009 to 2013. The study employs non-parametric approaches to estimate efficiency and productivity. Result records that new CDHs were performing relatively better than experienced CDHs and the productivity change was largely derived by growth or regress in technical change. Using Mann-Whitney-U test we rejected the null hypothesis that the distribution of technical efficiency was equal across new and experienced CDHs since P -value was less than 5%. The paper suggests that policy makers, government, and hospitals owners should invest in new technology as main deriving factor of productivity in CDHs. Conclusively, this paper holds that experience of operating as CDHs does not matters when it comes to improvement of hospitals’ efficiency. Interestingly, experience of operating as CDHs does not necessarily imply superiority in the performance

Issue Section: Economics

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References

Banker, R.D., Charnes, A; andCooper, W.W. (1984). ‘Models of Estimating Technical and Scale Efficiencies in Data Envelopment Analysis.’Management science 30. No.9. 1078 –1092Barnum DT., Walton, SM., Shield, KL and Schumock, GT (2009). Measuring hospitals efficiency with data envelopment analysis (DEA): Non-substitutable Vs substitutable inputs –outputs, Journal of Medical system 35, pp 1393 –401Boulenger and Criel, D (2012) The Difficult Relationship Between Faith-Based Healthcare Organization and public Sector In Sub-Saharan Africa: The Case Of Contracting Experience in Cameroon, Tanzania, chad and Uganda,Studies In Health Services Organization And Policy, 29, ISBN 9789076070391Caves, D.W., Christensen L, and Diewert, E. (1982). Economic Theory of Index Numbers and Measurementof Inputs, Outputs, and Productivity. Econometrical, 50 (6); 1393-1414.Chang, L and Lan, Y. (2010). Has the National Health Insurance Scheme Improved Hospitals Efficiency in Taiwan?, Identify Factors That Has Affect Its Efficiency, African Journal of Business Management, Vol 4 (17) pp3752 -3760Charness, A., Cooper, WW and Rhodes, E (1978) Measuring the Efficiency of Decision making units, European Journal of operational research 2, pp 429 –444Chilingerian. J.A. (1995). Evaluating Physician Efficiency in Hospitals: A multivariate Analysis of Best practices, European Journal of Operational Research, Vol, 80, pp548 –574Duckett, SJ (2003). The Australian Healthcare System. Melbourne:Oxford University PressEuropean Journal of Operation Research 2(6) 429–444.Charnes, A, Cooper, W and Rhodes E. (1978). Measuring the Efficiency of Decision Making Units, Farrel M.J. (1957). The Measurement of Productive Efficiency,Journal of the Royal Statistical Society Series –General120(3): 253 –290.

Farzianpour F., Arab M., Fourosharu AR., Rashidian, A (2011) Evaluation of International Standards Of Quality Improvement And Patients Safety (QPS) in Hospitals of Tehran University of Medical Science (TUMS) from Managers Point of View,World Applied Science Journal Vol15, pp 647 –53.Flouku A., Kontodimopolous, N and Niakos, D (2011). Employing Post –DEA Cross evaluation and Cluster analysis in a sample of Greek NHS hospitals, Journal of Medical Systems, 35 pp 1001 -14Gitusi, D,.Criel, B and de Bethune (1997). Viewpoint: Public Vs Private Healthcare delivery. Beyond the slogans.Health Policy and Planning 12, 193 -8Jehu-Appia, C., Sekkide, S., Adjuik, M., Akazili, J., Almeida, D.S., Nyanator, F., Baltusen, R., oZere, E and Kirigia, J.M. (2014). Ownership and Technical Efficiency of Hospitals: Evidence from Ghana Using Data Envelopment Analysis,Journal of Cost Effectiveness and Resource Allocation, Vol 12.Kirigia, J. M., Emrouznejad, A., Cassoma, B., Asbu, E. Z., & Barry, S. (2008). A Performance Assessment Method for Hospitals: The Case of Municipal Hospitals in Angola.Journal of Medical Systems,32(6), 509-519.Kirigia, JM., Mensah, A.O. Mwikisa, CN. Asbu, E.Z., Emrouznejad, A., Makoudode, P., Hounnankan, A. (2010). Technical Efficiency of zone hospitals in Benin, The African Health Monitor Vol, 12, pp20 –39.Malmquist, S. (1953). Index Numbers and Indifference Surfaces.Trabajos de Estadistica y de Investigation Operative,4(2), 209-242.Masiye, F. (2007). Investigating Health System Performance: an Application of Data Envelopment Analysis to Zambian Hospitals, BMC Health Services Research, Vol 7, No 58.Mc Kee, M and Healy, J (2002). The Significance of hospitals: An introduction in hospitals in changing Europe.In McKee, M and Healy (editors), European on health care system. Philadelphia: Open University PressMoHSW (2011) Ministry of Health Sector and Social welfare; Public Private Partnership (PPP) policy guidelines, available at www.moh.go.tzMin, H., Min, H., Joo, S.J. and Kim, J. (2009), “Evaluating the financial performances of Korean luxury hotels using data envelopment analysis”, The Service Industries Journal, 29(6):835-45Nyhan, R.C. and Peter, L.C. (2000), “Comparative performance assessment in managed care:DataEnvelopment Analysis for health care manager”, Management Care Quarterly, 8(1):18-27.Nikotic, I and Maikisch, H (2006) Public-Private Partnerships and collaboration in the health sector.An overview of the case study from the recent European experience, HND, The discussion paper, the World BankNishimizu, Mieko and John M., Page, Jr. (1982). Total Factor Productivity Growth Technological Progress and Technical Efficiency Change: Dimensions, The Economic Journal, Vol.92, No 368, pp920-936.Osei, D.,d'Almeida, S., George, M. O., Kirigia, J. M., Mensah, A. O., & Kainyu, L. H. (2005). Technical Efficiency of Public District Hospitals and Health Centers in Ghana: A Pilot Study.Cost Effectiveness and Allocation,Resource 3(1), 9.Palmer, N (2000).The Use of Private Sector Contracts for Primary Healthcare: Theory, Evidence, and Lessons for Low –Income and Middle-Income Countries. Bulletin of the World Health Organization 78 (6), 821-829Tlotlego, N., Justice, N., Sambo, LG., Zere, E and Kirigira, J.M. (2010). Assessment of Productivity of Hospitals in Botswana: A DEA Application,International Archive of Medicine, Vol 3.

Totledo, N., Nonvignon, J., Sambo, LG., Azbu, EZ, and Kirigia, JM. (2010) Assessment of productivity of hospitals In Botswana: A DEA Application,International Archive of Medicine 3, No 27URT –Census Result (2012). Available at www.nbs.go.tzWHO (2015) Report. Available at http:// www.who.int/gho/enYaiswarng, S (2002) Performance measurement and resource allocation. In Fox KJ (Editor) Efficiency in the Public sector. Boston, Kluwer Academic PublishersYawe, B. (2006). Total Factor Productivity Growth in Uganda’s District Referral Hospital, Makerere University, Department of Economic Theory and Analysis. Available at http://www.dspace.mak.ac.ug/handle/10570/858.Yawe, B. (2010). Hospital Performance Evaluation in Uganda. A Super efficiency Data Envelopment Analysis. Zambia Social Science Journal. Vol. 1, No 1 pp79 –105.Yuan, J., Wang, C, Skibnieweski, MJ, and Li, Q (2012). Developing Key performance indicators for public-private partnership project: Questionnaire Survey and Analysis, Journal of Management in Engineering Vol 28 pp252 -264Zere, E., Mbeeli, T., Shanguki, K., Mandalhate C., Mutirua K., Tijivambi B, Kapenambili W. (2006). Technical Efficiency of District Hospitals: Evidence from Namibia using Data Envelopment Analysis,Journal of CostEffectiveness and Resource Allocation, Vol. 4, No 5.Zere, E., Mcintyre, D and Addison, T. (2001). Technical Efficiency and Productivity of Public Sector Hospitals in Three South African Provinces, South African Journal of Economics, Vol 69, No 2 pp 336-358