Efficiency of outpatient clinics in Matanzas, Cuba, using data envelopment analysis

To rate the efficiency of all the outpatient clinics in Matanzas, Cuba; identify the best-performing clinics; and find opportunities for improvement at the others. A descriptive study of the 40 outpatient clinics in the province of Matanza was carried out during the first trimester of 2006. Clinics were grouped according to the complexity of services they offer and the socioeconomic level of the municipality in which they are located. Five output and six input variables were analyzed. Calculations were performed using data envelopment analysis, including optimization of results and constant and variable returns-to-scale. In general, the clinics studied had high efficiency rates, with a mean of 0.95 +/- 0.11. Eleven (27.5%) clinics studied were rated inefficient (0.77 +/- 0.12). The following Three key areas for improvement were identified: increasing tuberculosis detection rates in the community, reducing rates of preventable infant mortality, and expanding immunization coverage. Among the 11 clinics rated as inefficient, there were resource gaps in at least one indicator. By recognizing successful clinics, best practices were identified that could be used to improve the weaker clinics. The resource distribution process should be reviewed to ensure that additional, unneeded resources are not used to improve efficiency.