贫困国家综合医院配置效率低下:以乌干达为例

Max Ajanga
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引用次数: 0

摘要

主要由于人口增长和非传染性疾病的出现,保健费用不断增加,这对贫穷国家的保健预算造成了压力。在乌干达,要实现世卫组织建议的占国内生产总值15%的目标,资金缺口为7%,因此医院需要有效分配财政资源,以提供所需水平的卫生保健服务。大多数关于乌干达的研究都集中在综合医院的技术效率低下上,关于其配置效率低下的证据有限。了解乌干达综合医院资金分配效率低下的根源对提高其绩效非常重要。这项研究的目的是确定乌干达综合医院的分配效率低下,以便提供滥用公共拨款给某一综合医院的来源。使用了1997-2007年期间22家综合医院的小组数据。利用随机前沿分析估计分配效率低下。调查结果表明,综合医院在分配公共资金方面存在系统配置效率低下的问题。分配效率低下价值最高的是支付员工福利(34.8%),其次是购买药品(29.2%),最后是水电等公用事业费用(14.1%)。为了解决目前分配效率低下的问题,乌干达的综合医院可以改进雇用劳动力和管理工作人员工资的过程;监督药品采购,减少公用事业使用中的浪费。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Allocative Inefficiency of General Hospitals in Poor Countries: A Case Study of Uganda
The increasing costs of healthcare arising largely from the growing population and emergence of non-communicable diseases have exerted pressure on healthcare budgets in poor countries. With a funding gap of 7% to realize WHO recommended target of 15 percent of GDP in Uganda, there is a need for hospitals to be efficient in allocation of financial resources in order to provide the required level of healthcare services. Most studies on Uganda have focused on the technical inefficiency of general hospitals and evidence on their allocative inefficiency is limited.  Understanding the sources of inefficiency in the allocation of finances in general hospitals in Uganda is important to improve their performance. The purpose of this study was to determine the allocative inefficiency of the general hospitals in Uganda in order to provide a source of misuse of public allocations to a particular general hospital. Panel data from 22 general hospitals for the period 1997-2007 were used. Allocative inefficiency was estimated using Stochastic Frontier Analysis. The findings show that general hospitals are systematically allocatively inefficient in distributing the public funds given to them.  The allocative inefficiencies value is high on payments of employee benefits (34.8 percent), followed by the purchase of drugs (29.2%) and lastly, costs on utilities like electricity and water (14.1%). To address the existing allocative inefficiencies, general hospitals in Uganda can improve the process of hiring of labour and management of staff payroll; monitor procurement of drugs, and reduce wastages in the use of utilities.
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