Background
Public hospitals under the Office of Permanent Secretary, Ministry of Public Health have critical shortage in health workers. The area-based network consolidations of public hospitals should help to enhance capacity of the health system from allocation improvement in limited resources.
Methods
This study calculates the counterfactual simulations of area-based network allocations for health workforce in 10,500 public hospitals. The network consolidations at the sub-district, district, provincial, or health-region levels allow health workforce reallocation within local network areas. This study examines improvements in the allocative efficiency from the health workforce redistribution. The workload per worker is calculated from the output measured by numbers of outpatient and inpatient cases and the input measured by numbers of health workers. Both output and input are weighted with their economic values, controlled for heterogeneity by regression analysis. The weights assigned to each outpatient and inpatient case reflect the relative health system resources predicted for each discharge. Finally, this study compares the status quo and ex ante scenarios, as before and after network consolidations.
Results
Network consolidations of the primary-level hospitals within the same district could averagely reduce workload per worker by 14%. Another practical policy option is that consolidating similar hospital levels such as primary, first-level secondary, and mid-level secondary hospitals altogether within the same district could reduce the workload per worker by 17%.
Conclusion
This study illustrates improvement in allocative efficiency of health workforce in public hospitals from the area-based network consolidations. The results provide an insightful example of efficiency gains from reallocating medical workforce within the same local areas.
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Posted 15 Mar, 2021
On 29 Mar, 2021
Received 29 Mar, 2021
On 15 Mar, 2021
Received 15 Mar, 2021
Invitations sent on 11 Mar, 2021
On 03 Mar, 2021
On 03 Mar, 2021
On 01 Mar, 2021
On 01 Mar, 2021
Posted 15 Mar, 2021
On 29 Mar, 2021
Received 29 Mar, 2021
On 15 Mar, 2021
Received 15 Mar, 2021
Invitations sent on 11 Mar, 2021
On 03 Mar, 2021
On 03 Mar, 2021
On 01 Mar, 2021
On 01 Mar, 2021
Background
Public hospitals under the Office of Permanent Secretary, Ministry of Public Health have critical shortage in health workers. The area-based network consolidations of public hospitals should help to enhance capacity of the health system from allocation improvement in limited resources.
Methods
This study calculates the counterfactual simulations of area-based network allocations for health workforce in 10,500 public hospitals. The network consolidations at the sub-district, district, provincial, or health-region levels allow health workforce reallocation within local network areas. This study examines improvements in the allocative efficiency from the health workforce redistribution. The workload per worker is calculated from the output measured by numbers of outpatient and inpatient cases and the input measured by numbers of health workers. Both output and input are weighted with their economic values, controlled for heterogeneity by regression analysis. The weights assigned to each outpatient and inpatient case reflect the relative health system resources predicted for each discharge. Finally, this study compares the status quo and ex ante scenarios, as before and after network consolidations.
Results
Network consolidations of the primary-level hospitals within the same district could averagely reduce workload per worker by 14%. Another practical policy option is that consolidating similar hospital levels such as primary, first-level secondary, and mid-level secondary hospitals altogether within the same district could reduce the workload per worker by 17%.
Conclusion
This study illustrates improvement in allocative efficiency of health workforce in public hospitals from the area-based network consolidations. The results provide an insightful example of efficiency gains from reallocating medical workforce within the same local areas.
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