Performance evaluation of the districts' primary health care system in Iran; A case study

Managers need to evaluate the performance of their subordinates in order to plan, organize, and improve the performance of their organizations. In this study, the performance and efficiency of the district's primary health care (PHC) system in the southeast of Iran were evaluated using the data envelopment analysis (DEA) model.

In this study, the efficiency of 9 cities affiliated to Kerman University of Medical Sciences was analyzed in 2019. The quantitative non-parametric DEA was used to evaluate the performance of the PHC system in the districts. Human forces, physical facilities, and vehicles were the variables used as the inputs, and the number of services and service recipients was considered as the outputs to measure efficiency. Data collection was done in the field using a checklist. The data were analyzed using the DEAP 2.1 software, efficiency was calculated with the output maximization approach and the assumption of variable returns to scale. It was carried out as linear programming with nine scenarios for nine districts in 2018.

The mean efficiency of the studied districts with the assumption of variable returns to scale was 0.68, indicating at least 32% capacity to increase efficiency in the studied PHC systems without any increase in production factors. According to the mean values, Kerman was efficient while the other 8 districts were inefficient. The most inefficient PHC systems were those of Shahr-e Babak, Baft, and Orzooieh.

Inefficiency in most PHC systems of the studied districts, indicating that PHC managers can provide more health services to the community through proper management of available resources. Inefficient districts can compare themselves with successful and reference districts to eliminate their shortcomings and improve their performance.