Exploring the influence of context and policy on health district productivity in Cambodia

Cost Effectiveness and Resource Allocation : C/E
Tim EnsorSophie Witter

Abstract

Cambodia has been reconstructing its economy and health sector since the end of conflict in the 1990s. There have been gains in life expectancy and increased health expenditure, but Cambodia still lags behind neighbours One factor which may contribute is the efficiency of public health services. This article aims to understand variations in efficiency and the extent to which changes in efficiency are associated with key health policies that have been introduced to strengthen access to health services over the past decade. The analysis makes use of data envelopment analysis (DEA) to measure relative efficiency and changes in productivity and regression analysis to assess the association with the implementation of health policies. Data on 28 operational districts were obtained for 2008-11, focussing on the five provinces selected to represent a range of conditions in Cambodia. DEA was used to calculate efficiency scores assuming constant and variable returns to scale and Malmquist indices to measure productivity changes over time. This analysis was combined with qualitative findings from 17 key informant interviews and 19 in-depth interviews with managers and staff in the same provinces. The DEA results suggest great variation in...Continue Reading

References

Jan 5, 2002·Journal of Medical Systems·Joses M KirigiaLuis G Sambo
Dec 18, 2003·Health Policy and Planning·Wim HardemanBruno Meessen
Dec 16, 2005·BMC Health Services Research·Ade RennerLenity H K Muthuri
Mar 29, 2006·Cost Effectiveness and Resource Allocation : C/E·Eyob ZereWilliam Kapenambili
Dec 21, 2006·Health Economics·Pablo Arocena, Ariadna García-Prado
Jan 20, 2007·Journal of Medical Systems·Felix MasiyeDavid Okello
Aug 4, 2009·Bulletin of the World Health Organization·Maryam Bigdeli, Peter Leslie Annear
Jul 11, 2013·International Journal for Equity in Health·Antonia DingleCatherine Goodman

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Software Mentioned

Data Envelopment Analysis Programme ( DEAP )
DEA

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