Technical efficiency of women’s health prevention programs in Bucaramanga, Colombia: a four-stage analysisReport as inadecuate

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BMC Health Services Research

, 16:576

Health systems and services in low and middle income settings


BackgroundPrimary Health Care PHC is an efficient strategy to improve health outcomes in populations. Nevertheless, studies of technical efficiency in health care have focused on hospitals, with very little on primary health care centers. The objective of the present study was to use the Data Envelopment Analysis to estimate the technical efficiency of three women’s health promotion and disease prevention programs offered by primary care centers in Bucaramanga, Colombia.

MethodsEfficiency was measured using a four-stage data envelopment analysis with a series of Tobit regressions to account for the effect of quality outcomes and context variables. Input-output information was collected from the institutions’ records, chart reviews and personal interviews. Information about contextual variables was obtained from databases from the primary health program in the municipality. A jackknife analysis was used to assess the robustness of the results.

ResultsThe analysis was based on data from 21 public primary health care centers. The average efficiency scores, after adjusting for quality and context, were 92.4 %, 97.5 % and 86.2 % for the antenatal care ANC, early detection of cervical cancer EDCC and family planning FP programs, respectively. On each program, 12 of the 21 57.1 % health centers were found to be technically efficient; having had the best-practice frontiers. Adjusting for context variables changed the scores and reference rankings of the three programs offered by the health centers.

ConclusionThe performance of the women’s health prevention programs offered by the centers was found to be heterogeneous. Adjusting for context and health care quality variables had a significant effect on the technical efficiency scores and ranking. The results can serve as a guide to strengthen management and organizational and planning processes related to local primary care services operating within a market-based model such as the one in Colombia.

KeywordsTechnical efficiency Primary health care Data Envelopment Analysis Prevention Women Colombia Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1837-0 contains supplementary material, which is available to authorized users.

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Author: Myriam Ruiz-Rodriguez - Laura A. Rodriguez-Villamizar - Ileana Heredia-Pi


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