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International Journal of Public Health and Clinical Sciences (IJPHCS)
Open Access e-journal ISSN : 2289-7577


Arinah W.D.S., Muhamad Hanafiah Juni



Background: Primary care services are delivered through health clinics. Issue of resource scarcity and wastage cannot be denied in health care. Evaluating efficiency of health clinics will provide information on resource utilization, therefore optimization of resources used can be carried out. Several techniques used to measure efficiency including data envelopment analysis (DEA). Environmental variables have been documented to have impact on values of efficiency score and rank of units. Knowledge on the environmental variables used in measuring efficiency of health clinic to equip policy makers with more accurate results and subsequently assist in decision making. The aim of this manuscript is to review literature on environmental variables used in measuring efficiency of health clinics with DEA.

Materials and Methods: A review was conducted using online databases namely Pub Med, Science Direct, CINAHL and MEDLINE to identify articles and publications that were related to measuring efficiency in health clinics using DEA. 

Result: 423 studies were obtained from the initial search. After excluding non-English literature, limiting publication from year 2007 and applying inclusion and exclusion criteria, a total of 11 publications were selected for review.

Conclusion: This review identified different environmental variables used in measuring efficiency of health clinics. The variables can be categorized into staff characteristics, patient characteristics, facility characteristic and others. Many variables were also found to be significant in affecting efficiency of health clinics regardless of the stage of DEA used. Taking into consideration the importance of environmental variables, they should be included in measuring efficiency of health clinic. It will help health managers to make an informed decision.

Keywords: data envelopment analysis, efficiency, health clinic, primary care, environmental variables

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