Technical and scale efficiency of health centers in Bangkok Metropolitan area

Abstract

To measure the technical and scale efficiency of 68 health centers in Bangkok Metropolitan Area from 2009 - 2010 as 136 decision making units (DMUs). Data envelopment analysis (DEA) method is used to analyze technical and scale efficiency and ordinary least square regression is used to analyze the determinants of efficiency. DEA results showed the average technical efficiency under constant return to scale assumption (TEcrs) was 0.8866, the average technical efficiency under variable return to scale assumption (TEvrs) was 0.9268, and the average scale efficiency was 0.9553. There were 55 efficient DMUs from 136 DMUs for overall technical efficiency scores that 40.44% of DMUs were overall technical efficiency. There were 86 efficient DMUs from 136 DMUs that 61.76% of DMUs were pure technical efficiency (TEvrs) and there were 58 efficient DMUs from 136 DMUs that 42.65% of DMUs were scale efficiency. For the OLS regression, it found that the ratio of doctor to other staff, the ratio of nurse to other staff, the ratio of general patient visits to doctor, the ratio of family planning to nurse had a positive impact on pure technical efficiency (TEvrs) scores. The ratio of dentist to other staff had a negative impact on pure technical efficiency (TEvrs) scores. For scale efficiency scores, the result revealed the number of doctor had a positive relationship with scale efficiency (SE) scores. All above information could be used for policy makers in health sector of BMA to improve inefficient health centers in proper direction such as most of the pattern of scale inefficiency were increasing return to scale which can be improved through up-sizing. Focusing on increasing number of doctors should be one solution to be considered because from the study showed that the ratio of doctor to other staffs and number of doctors significantly related to efficiency scores.