Evaluating the efficiency and economic savings levels among primary healthcare units in rukungiri district, Uganda: a non-parametric model

Abstract

Introduction: The scarcity and shortage of resources in health systems in developing countries continues to draw attention, tension and debate among stakeholders, and this calls for evaluation of efficiency in healthcare markets. Objectives: The purpose of the study is to analyse the efficiency and level of economic savings among public health centre II facilities in Rukungiri District, Uganda. Two specific objectives guided the study: estimating the technical and scale efficiency scores and the economic saving levels among the primary healthcare facilities. Methodology: A cross-sectional descriptive research design was used and secondary data containing health inputs and outputs that was secured from the District Health Information System (DHIS-2) for the financial year 2022/2023. A Constant Returns to Scale (CRS) output-oriented Data Envelopment Analysis (DEA) technique was adopted to evaluate the level of technical, scale efficiency and slack values for economic savings that are needed to make inefficient health units efficient. Results: An average technical efficiency level of 43.7 percent was estimated implying that facilities need to improve on resource utilization by 56.3 percent to become technically efficient. Scale efficiency averaged 99.7 percent and this means that the facilities were scale efficient given their size. Economic savings arising from input reductions and output augmentations were registered. Conclusion: This study fills the research gap by estimating the technical and scale efficiency scores for each facility as a decision making unit in the district. It provides a novel and detailed understanding of how much economic savings would be made if technically inefficient facilities avoid wastage of input resources to attain efficiency. It also identifies the benchmark facilities from which inefficient ones need to emulate to become efficient.