Efficiency differences among hospitals and surgical departments in Ukraine

Abstract

The study analyses the technical efficiency and the efficiency change of 193 community hospitals and polyclinics across Ukraine, for the years 1997 to 2001. These facilities are a subset of the medical institutions in rural Ukraine; they are identical w.r.t. their function in the health system and share the same departmental structure. The data comprise the number of physicians and the number of nurses employed in the departments as well as the polyclinics attached to the hospitals, the number of inpa- tient and outpatient admissions as well as the number of surgical procedures, lab tests and x-rays performed. Finally, the number of deaths and deaths after surgery are used as quality proxies. We employ an order-m estimator, a robust nonparametric technique to assess the ef- ficiency of health care providers as well as possible changes of their productivity. The efficiency scores are calculated with an output-oriented model. Efficiency scores are close to unity for hospitals whereas polyclinics are somewhat less efficient. The Malm- quist index exceeds unity for three out of four periods for both hospitals and polyclinics indicating improved productivity on average.