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Association between efficiency and quality of care of public healthcare facilities: Evidence from Pakistan

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  • Saima Bashir
  • Muhammad Nasir
  • Katja Grasic
  • Marc Moulin
  • Shehzad Ali

Abstract

Background Maternal and child health is an important component of the Sustainable Development Goals. Pakistan has one of the worst maternal and neonatal health outcomes in the world. This is despite significant health system investments across the country. Aims The objectives of this study are twofold. First, the study estimates the technical efficiency of the public healthcare facilities in Pakistan, defined as the number of obstetric deliveries compared to the number of medical specialists, nurses, and other health and non‐health staff members. Second, the study evaluates the relationship between efficiency and quality of care; the latter is measured in terms of maternal and neonatal mortality. Materials & Methods The data were taken from the Pakistan Health Facility Assessment Survey. Efficiency score was calculated for 843 public healthcare facilities, using Stochastic Frontier Analysis. We then used two‐stage residual inclusion approach with bootstrapping to evaluate the relationship between efficiency and quality. Results and Discussion The average efficiency score was 0.48 (range: 0–1) and none of the public healthcare facilities were on the frontier, implying that efficiency gains can be made across the board. The relationship between efficiency and quality is found to be positive and statistically significant, that is, more efficient healthcare facilities also had lower rates of maternal and neonatal mortality. Conclusion We conclude that more efficient public healthcare facilities also had lower mortality rates, probably due to better infrastructure and health system financing.

Suggested Citation

  • Saima Bashir & Muhammad Nasir & Katja Grasic & Marc Moulin & Shehzad Ali, 2022. "Association between efficiency and quality of care of public healthcare facilities: Evidence from Pakistan," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 2240-2255, July.
    • Handle: RePEc:bla:ijhplm:v:37:y:2022:i:4:p:2240-2255
    DOI: 10.1002/hpm.3465
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    1. Murad Ali & Megersa Debela & Tewfik Bamud, 2017. "Technical efficiency of selected hospitals in Eastern Ethiopia," Health Economics Review, Springer, vol. 7(1), pages 1-13, December.
    2. Jan Clement & Vivian Valdmanis & Gloria Bazzoli & Mei Zhao & Askar Chukmaitov, 2008. "Is more better? An analysis of hospital outcomes and efficiency with a DEA model of output congestion," Health Care Management Science, Springer, vol. 11(1), pages 67-77, March.
    3. Haroon Jamal, 2016. "Spatial Disparities in Socioeconomic Development: The Case of Pakistan," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 55(4), pages 421-435.
    4. Hentschker, Corinna & Mennicken, Roman, 2012. "The Relationship between Quality and Hospital Case Volume – An Empirical Examination with German Data," Ruhr Economic Papers 341, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
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    1. Zahid Hussain & Chunhui Huo & Ashfaq Ahmad & Wasim Abbas Shaheen, 2024. "An assessment of economy- and transport-oriented health performance," Health Economics Review, Springer, vol. 14(1), pages 1-20, December.

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