Analysis of the efficiency of hospitals in Senegal: a DEA method application

Summary Aims: The objectives of this study were to quantify the technical efficiency of hospitals in Senegal, and to evaluate changes in efficiency over a five years period due to technology change. Methods: Data Envelopment Analysis method (DEA) was used to quantify hospital technical efficiency. The Malmquist index permits to evaluate change in productivity due to change in technology. Results: The analysis revealed that hospitals show on the whole only 68% of efficiency. Then, for being efficient, they must improve their output by 32%. Hospitals with 200-300 beds present bigger efficiency score than small hospitals with less than 200 beds. Those hospitals also benefit more technical progress effect than others while they are few in the health system compared to smaller hospitals that have the lowest efficiency scores. Conclusion: Small hospital that the literature find more efficient for developing countries show the lowest efficiency score. These results imply small hospitals to be merged for benefiting economies of scale. However, the merging politic counters to the equity research in equal access to hospital's healthcare and also counters to WHO's performance criteria like the number of person covered by a hospital. In addition, this analysis is nuanced and efficiency could possibly be improved. Beyond the size of small hospitals, the interest remains to know whether or not it is efficient to combine different type of healthcare at the same facility. Prat Organ Soins. 2012;43(4):277-283