Assessing Hospital Performance in Indonesia: An Application of Frontier Analysis Techniques

Despite increased national health expenditure in health facilities in Indonesia, health outcomes remain poor. The aim of our study is to examine the factors determining the relative efficiency of hospitals. Using linked national data sources from facility-, households, and village-based surveys, we measure the efficiency of 200 hospitals across fifteen provinces in Indonesia with output oriented data envelopment analysis (DEA) and stochastic frontier analysis (SFA). Inputs include the number of doctors, nurses and midwives, other staff, and beds while outputs are the number of outpatient visits and bed-days. We run truncated regression in second stage DEA and one stage SFA analysis to assess contextual characteristics influencing health facilities performance. Our results indicate a wide variation in efficiency between health facilities. High-performing hospitals are in deprived areas. Hospitals located in less concentrated health facilities, in Java and Bali Island, high coverage of insurance scheme for the poor perform better than in other geographical location. We find an inconclusive impact of quality of care, and ownership on efficiency. This paper concludes by highlighting the characteristics of hospitals that have the potential to increase efficiency