Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings
Abstract Background The assessment of hospital efficiency is attracting interest worldwide, particularly in Gulf Cooperation Council (GCC) countries. The objective of this study was to review the literature on public hospital efficiency and synthesise the findings in GCC countries and comparable set...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | Cost Effectiveness and Resource Allocation |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12962-019-0185-4 |
| _version_ | 1818407944581021696 |
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| author | Ahmed Alatawi Sayem Ahmed Louis Niessen Jahangir Khan |
| author_facet | Ahmed Alatawi Sayem Ahmed Louis Niessen Jahangir Khan |
| author_sort | Ahmed Alatawi |
| collection | DOAJ |
| description | Abstract Background The assessment of hospital efficiency is attracting interest worldwide, particularly in Gulf Cooperation Council (GCC) countries. The objective of this study was to review the literature on public hospital efficiency and synthesise the findings in GCC countries and comparable settings. Methods We systematically searched six scientific databases, references and grey literature for studies that measured the efficiency of public hospitals in appropriate countries, and followed PRISMA guidelines to present the results. We summarised the included studies in terms of samples, methods/technologies and findings, then assessed their quality. We meta-analysed the efficiency estimates using Spearman’s rank correlations and logistic regression, to examine the internal validity of the findings. Results We identified and meta-analysed 22 of 1128 studies. Four studies were conducted in GCC nations, 18 came from Iran and Turkey. The pooled technical-efficiency (TE) was 0.792 (SE ± 0.03). There were considerable variations in model specification, analysis orientation and variables used in the studies, which influenced efficiency estimates. The studies lacked some elements required in quality appraisal, achieving an average of 73%. Meta-analysis showed negative correlations between sample size and efficiency scores; the odd ratio was 0.081 (CI 0.005: 1.300; P value = 0.07) at 10% risk level. The choice of model orientation was significantly influenced (82%) by the studied countries’ income categories, which was compatible with the strategic plans of these countries. Conclusions The studies showed methodological and qualitative deficiencies that limited their credibility. Our review suggested that methodology and assumption choices have a substantial impact on efficiency measurements. Given the GCC countries’ strategic plans and resource allocations, these nations need further efficiency research using high-quality data, different orientations and developed models. This will establish an evidence-based knowledge base appropriate for use in public hospital assessments, policy- and decision-making and the assurance of value for money. |
| first_indexed | 2024-12-14T09:35:53Z |
| format | Article |
| id | doaj.art-7081f68daf3a4857884c751f48094e09 |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-12-14T09:35:53Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-7081f68daf3a4857884c751f48094e092022-12-21T23:07:55ZengBMCCost Effectiveness and Resource Allocation1478-75472019-08-0117111210.1186/s12962-019-0185-4Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settingsAhmed Alatawi0Sayem Ahmed1Louis Niessen2Jahangir Khan3Health Economics Group, Department of Clinical Sciences, Liverpool School of Tropical Medicine, LSTMHealth Economics Group, Department of Clinical Sciences, Liverpool School of Tropical Medicine, LSTMHealth Economics Group, Department of Clinical Sciences, Liverpool School of Tropical Medicine, LSTMHealth Economics Group, Department of Clinical Sciences, Liverpool School of Tropical Medicine, LSTMAbstract Background The assessment of hospital efficiency is attracting interest worldwide, particularly in Gulf Cooperation Council (GCC) countries. The objective of this study was to review the literature on public hospital efficiency and synthesise the findings in GCC countries and comparable settings. Methods We systematically searched six scientific databases, references and grey literature for studies that measured the efficiency of public hospitals in appropriate countries, and followed PRISMA guidelines to present the results. We summarised the included studies in terms of samples, methods/technologies and findings, then assessed their quality. We meta-analysed the efficiency estimates using Spearman’s rank correlations and logistic regression, to examine the internal validity of the findings. Results We identified and meta-analysed 22 of 1128 studies. Four studies were conducted in GCC nations, 18 came from Iran and Turkey. The pooled technical-efficiency (TE) was 0.792 (SE ± 0.03). There were considerable variations in model specification, analysis orientation and variables used in the studies, which influenced efficiency estimates. The studies lacked some elements required in quality appraisal, achieving an average of 73%. Meta-analysis showed negative correlations between sample size and efficiency scores; the odd ratio was 0.081 (CI 0.005: 1.300; P value = 0.07) at 10% risk level. The choice of model orientation was significantly influenced (82%) by the studied countries’ income categories, which was compatible with the strategic plans of these countries. Conclusions The studies showed methodological and qualitative deficiencies that limited their credibility. Our review suggested that methodology and assumption choices have a substantial impact on efficiency measurements. Given the GCC countries’ strategic plans and resource allocations, these nations need further efficiency research using high-quality data, different orientations and developed models. This will establish an evidence-based knowledge base appropriate for use in public hospital assessments, policy- and decision-making and the assurance of value for money.http://link.springer.com/article/10.1186/s12962-019-0185-4Gulf countriesSystematic reviewTechnical efficiencyPublic hospitalsData envelopment analysisStochastic frontier analysis |
| spellingShingle | Ahmed Alatawi Sayem Ahmed Louis Niessen Jahangir Khan Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings Cost Effectiveness and Resource Allocation Gulf countries Systematic review Technical efficiency Public hospitals Data envelopment analysis Stochastic frontier analysis |
| title | Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings |
| title_full | Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings |
| title_fullStr | Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings |
| title_full_unstemmed | Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings |
| title_short | Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings |
| title_sort | systematic review and meta analysis of public hospital efficiency studies in gulf region and selected countries in similar settings |
| topic | Gulf countries Systematic review Technical efficiency Public hospitals Data envelopment analysis Stochastic frontier analysis |
| url | http://link.springer.com/article/10.1186/s12962-019-0185-4 |
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