Efficiency evaluation of public hospitals in Saudi Arabia: an application of data envelopment analysis

Alatawi, Ahmed, Niessen, Louis ORCID: https://orcid.org/0000-0002-8639-5191 and Khan, Jahangir ORCID: https://orcid.org/0000-0002-6151-764X (2020) 'Efficiency evaluation of public hospitals in Saudi Arabia: an application of data envelopment analysis'. BMJ Open, Vol 10, Issue 1, e031924.

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Abstract

Objective: In this study, we assess the performance of public hospitals in Saudi Arabia. We detect the sources of inefficiency and estimate the optimal levels of the resources that provide the current level of health services. We enrich our analysis by employing locations and capacities of the hospitals.

Design: We employ the Data Envelopment Analysis (DEA) to measure the technical efficiency of 91 public hospitals. We apply the input-oriented CCR and BCC models under constant and variable returns-to-scale (CRS and VRS). The assessment includes four inputs and six output variables taken from the Ministry of Health databases for 2017. We conducted the assessment via PIM-DEA 3.2 software.
Setting: Ministry of health-affiliated hospitals in the Kingdom of Saudi Arabia (KSA).

Results: Findings identified 75.8% (69 of 91) of public hospitals as technically inefficient. The average efficiency-score was 0.76, indicating that hospitals could have reduced their inputs by 24% without a reduction in health-service provision. Small hospitals, (efficiency-score 0.79), were more efficient than medium-sized and large hospitals. Hospitals in the central-region were more efficient (efficiency-score 0.83) than those located in other geographic-locations. More than half of the hospitals (62.6%) were operating sub-optimally in terms of the scale-efficiency, implying that to improve efficiency, they need to alter their production capacity. Performance analysis identified the overuse of physician’s numbers and shortage of health-services production, as major causes of inefficiency.

Conclusion: Most hospitals were technically inefficient and operating at sub-optimal scale size and indicate that many hospitals may improve their performance through efficient utilization of health resources to provide the current level of health services. Changes in the production capacity are required to facilitate optimal use of medical capacity. The inefficient hospitals could benefit from these findings to benchmarking their system and performance in light of the efficient hospital within their capacity and geographic location.

Item Type:	Article
Subjects:	WA Public Health > Health Administration and Organization > WA 540 National and state health administration WX Hospitals and Other Health Facilities > WX 100 General works WX Hospitals and Other Health Facilities > Hospital Administration > WX 150 General works WX Hospitals and Other Health Facilities > WX 20 Research (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjopen-2019-031924
Depositing User:	Julie Franco
Date Deposited:	16 Jan 2020 13:35
Last Modified:	16 Jan 2020 13:35
URI:	https://archive.lstmed.ac.uk/id/eprint/13522

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