Technical Efficiency of Public Hospitals in Senegal : A Data Envelopment Analysis with an Estimated Case Mix Index

In sub-Saharan Africa, hospitals absorb the greatest proportion of total health resources according to the World health Organization. Senegal is no exception to this, out of the total government expenditure in the health sector, a third is absorbed by public hospitals and specialized health institutes on average each year. This heavy use of health resources by the hospitals relative to other public health providers raises questions about how efficiently those scarce resources are used. This study assesses the technical and scale efficiency of Senegalese public hospitals using Data Envelopment Analysis. For Senegal, I find that the public hospitals’ technical efficiency mean of 0.969 is higher than what was found for African hospitals in general but, the mean scale efficiency of 0.881 is very similar. However, Senegal has technically inefficient hospitals that could be using fewer inputs for the actual level of output they are producing and the possible savings in inputs are not trivial, especially concerning the number of physicians. To reduce the waste in inputs, I would recommend their redistribution through an upgrade of the top health centers in the country, particularly in the regions without a hospital, into public hospitals