Bwana, M.K. The University of Dodoma 1st International Conference on Business and Economics
(ICBE), 21st March, 2019, 134-148
©JBE, The University of Dodoma ISSN: 2619-8657
Page 1
MODELING EFFICIENCY IN THE PRESENCE OF VOLUNTEERING
AGENCY HOSPITALS AND COUNCIL DESIGNATED HOSPITALS IN
TANZANIA: AN APPLICATION OF NON PARAMETRIC APPROACH
Kembo M. Bwana
Senior Lecturer, College of Business Education, Dodoma, Tanzania
Corresponding Author: kembo211@gmail.com
ABSTRACT
Health care industry has remained behind other sector in terms of objectives performance evaluation
perhaps is more serious in developing countries as compared to their counterpart (developed
countries). This study measures and compares efficiency of Council Designated Hospitals (CDHs) and
Volunteering Agency Hospitals (VAHs) in Tanzania. The study employs 34 hospitals (17 CDHs and 17
VAHs) in a non-parametric approach, known as Data Envelopment Analysis (DEA) model in the study
period that cover 2009 to 2013. The study adopted Mann Whitney U to test the null hypothesis that
mean distribution is equal across the CDHs and VAHs. The variables used include inpatients days,
outpatients visit, and total surgical operation as the outputs, while the hospitals beds and full time
equivalents (FTEs) were adopted as hospitals’ inputs. Findings records that mean variable return to
scale (VRTS) technical efficiency for CDHs was 0.744percent, 9 hospitals were found to be technically
efficient and 6were experiencing scale efficiency. Most of the hospitals were operating close to the
scale efficiency as they have mean scale efficiency of 0.88823 percent. On the other hand, the results
shows that VAHs hospitals had mean VRTS technical efficiency of 0.702 percent and 7 hospitals were
found to be scale efficient. Since the p-value is less than the 0.05 (5 percent) we rejected the null
hypothesis (at 5% level of significance) that Mean distribution of technical efficiency score is equal
across the CDHs and VAHs hospitals. The study recommends that hospitals experiencing decreasing
return to scale (DRS) or diseconomies of scale their size should be revisited to make them efficient.
This is because it seems the hospitals are too small for their activities, and therefore to make the
hospitals efficient restructuring is inevitable. On the other hand CDHs and VAHs experiencing
economies of scale should be equally supplied with health resources so as to increase their activities
hence becomes efficient, such hospitals are too big compared to their level of activities. This study
suggests that natural extension of this work should focus on how inefficient CDHs and VAHs could
improve their performance given the available scarce resources.
Key words: Modeling, Efficiency, Hospitals, Tanzania
1.0 INTRODUCTION
In health care systems, the efficiency measurements is usually the first steps in auditing
individual performance of production units such as hospitals or health centers. It involves the
rational frameworks for the allocation of human and other resources between and within the
health care facility (Kontodimopoulos et al 2006). Other researchers have gone far and try to
link the resource utilization and performance with hospital’s size or forms of ownership.