Measurement of efficiency of the Health Centres of Greece: the case for the Health Prefecture of Peloponnesos, Southern Greece, Epirus and Ionian Islands.

Doctoral Dissertation uoadl:1308537 307 Read counter

Τομέας Κοινωνικής Ιατρικής - Ψυχιατρικής και Νευρολογίας
Library of the School of Health Sciences
Deposit date:
Οικονόμου Νικόλαος
Dissertation committee:
Καθηγητής Ιωάννης Τούντας
Original Title:
Mέτρηση αποδοτικότητας των ελληνικών Kέντρων Υγείας - Περιφερειακών Ιατρείων: Η περίπτωση της περιφέρειας Πελοποννήσου, Δυτικής Ελλάδας, Ηπείρου και Ιονίων νήσων.
Translated title:
Measurement of efficiency of the Health Centres of Greece: the case for the Health Prefecture of Peloponnesos, Southern Greece, Epirus and Ionian Islands.
Objectives of the study:
1. To create a model that identifies the key inputs and outputs
of the Greek rural and semi-urban HCs and estimates their relative importance
(weights) on their production function.
2. The application of this model on the measurement of the total
technical efficiency, pure technical efficiency and scale efficiency efficiency
of the public HCs of the 6th Health Prefecture of Greece.
3. The running of a second stage analysis to explore the effects
of a serious of internal and external factors on the efficiency scores of the

Methods: The production of the model of inputs-outputs was fulfilled through
two multi-discipline panels of experts in Primary Health Care. The measurement
of the 3 forms of efficiency was based on data from the 50 HCs-RPs of the
Prefecture of Southern and Western Greece, gathered through a questionnaire.
The weight-restricted technique ‘Assurance Region’ of Data Envelopment Analysis
was applied in an output-oriented model, under constant and variable returns to
scale. The study of the factors determining efficiency of Greek primary care
units was based on the running of a second-stage DEA, HCs, and data for some
other characteristics of the HCs gathered by the same questionnaire.

Results: According to the results of the Delphi study, key inputs into the
production function of the Greek HCs is the size of their staff (physicians,
registered nurses / allied health professionals) and their technological
infrastructure (medical equipment and laboratories), whereas key outputs are
the ‘Greek Ambulatory Patient Groups (APGs).
Nine out of the 42 HCs which provided complete and trustworthy data, were
identified as technical efficient, five as scale efficient and two as total
efficient. The mean total efficiency, pure efficiency and scale efficiency
scores of the HCs of the 6th Health Prefecture were 0.57, 0.67 and 0.87,
The highest the distance of a HC of the 6th Health Prefecture to a hospital,
the lower its technical efficiency score.
The biggest the size of its catchment population, the larger its technical
efficiency score.
primary health care, data envelopment analysis, efficiency measurement, health centres, evaluation
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