Profit incentives and technical efficiency in the provision of health care in Zimbabwe: an application of data envelopment analysis and econometric methods

Abstract

This study examines issues surrounding efficiency in the Zimbabwean health sector with specific emphasis on for-profit hospitals in order to find out whether they are significantly more efficient than non-profit hospitals. The study attempts to explore the significance of profit incentives on efficiency. This study uses the Data Envelopment Analysis (DEA) methodology to examine hospital efficiency scores for the 100 hospitals in the sample classified as for-profit, mission and public. Outputs of the study include inpatient days and outpatient visits. The number of beds, doctors and nurses were used to capture hospital inputs. The findings indicated that there was a marked deviation of efficiency scores from the best practice frontier with for-profit hospitals having the highest mean PTE of 71.1%. The mean PTE scores for mission and public hospitals were 64.8% and 62.6% respectively. About 85 %, 83 % and 91 % of the for-profit, mission and public hospitals were found to be operating below their average PTE. More than half of the hospitals are being run inefficiently. Of more importance to this study is the fact that the hypothesis of for-profit hospital superiority was accepted implying that for profit hospitals are significantly more efficient than the non-profit category. The study indicated that the amount of inputs being used could be decreased substantially without decreasing the quantity of outputs achieved. In each of the hospitals included in the study, the total input reductions needed to make inefficient hospitals efficient are more than 50%. These input savings could go a long way in achieving other health concerns without mobilizing additional resources in the sector.