Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia
Abstract Background One of the most important ways to boost the health system’s performance and lower the rising cost of healthcare is to increase its efficiency. The objective of this study is to evaluate the efficiency of the MOH in providing public health services and to gauge the progress of hea...
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2025-04-01
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| Series: | Health Economics Review |
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| Online Access: | https://doi.org/10.1186/s13561-025-00624-9 |
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| author | M Zulfakhar Zubir Aizuddin A.N Mohd Rizal Abdul Manaf A Aziz Harith M Ihsanuddin Abas Maizatul Izyami Kayat M Firdaus M Radi Mas Norehan Merican Nurcholisah Fitra Affendi M Ali Sharifah Ain Shameera Syed Rusli |
| author_facet | M Zulfakhar Zubir Aizuddin A.N Mohd Rizal Abdul Manaf A Aziz Harith M Ihsanuddin Abas Maizatul Izyami Kayat M Firdaus M Radi Mas Norehan Merican Nurcholisah Fitra Affendi M Ali Sharifah Ain Shameera Syed Rusli |
| author_sort | M Zulfakhar Zubir |
| collection | DOAJ |
| description | Abstract Background One of the most important ways to boost the health system’s performance and lower the rising cost of healthcare is to increase its efficiency. The objective of this study is to evaluate the efficiency of the MOH in providing public health services and to gauge the progress of health plans in Malaysia. Methods Three output variables (number of admissions, number of outpatient attendances, and number of maternal and child health attendances) and six input variables (budget allocation, number of doctors, dentists, pharmacists, nurses, and community nurses) were used in a Data Envelopment Analysis (DEA) Window Analysis. Eight input-output models’ bias-corrected efficiency scores were obtained using bootstrapping. Setting Ministry level in public health service. Participant 28 Decision making units (DMUs) from 1995 to 2022. Results Robust performance over the study period was shown by the mean bias-corrected efficiency score of 0.974 (95% CI: 0.907–0.989) under the Variable Returns to Scale (VRS) model. Lower Constant Returns to Scale (CRS) model scores, on the other hand, draw attention to scale-level inefficiencies. During the COVID-19 pandemic, efficiency decreased due to higher input demands and limited outputs. Conclusions Although MOH has attained a high level of technological efficiency, expanding operations and resolving inequalities in rural areas remain difficult. Targeted tactics including telemedicine adoption, resource redistribution, and a move towards preventive treatment are advised in order to improve fairness and resilience. |
| format | Article |
| id | doaj-art-5a013802dcaa44eeabc256ec038e50e7 |
| institution | DOAJ |
| issn | 2191-1991 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Economics Review |
| spelling | doaj-art-5a013802dcaa44eeabc256ec038e50e72025-08-20T03:06:48ZengBMCHealth Economics Review2191-19912025-04-0115111410.1186/s13561-025-00624-9Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health MalaysiaM Zulfakhar Zubir0Aizuddin A.N1Mohd Rizal Abdul Manaf2A Aziz Harith3M Ihsanuddin Abas4Maizatul Izyami Kayat5M Firdaus M Radi6Mas Norehan Merican7Nurcholisah Fitra8Affendi M Ali9Sharifah Ain Shameera Syed Rusli10Medical Development Division, Ministry of Health MalaysiaDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaOccupational Health Research Centre, Institute for Public Health, Ministry of HealthDepartment of Public Health, Faculty of Medicine, Universiti Sultan Zainal AbidinMedical Development Division, Ministry of Health MalaysiaMedical Development Division, Ministry of Health MalaysiaPublic Health Development Division, Ministry of Health MalaysiaFaculty of Public Health, University of North SumatraDepartment of Social and Preventive Medicine, Universiti Malaya Medical CentreDisease Control Division, Ministry of Health MalaysiaAbstract Background One of the most important ways to boost the health system’s performance and lower the rising cost of healthcare is to increase its efficiency. The objective of this study is to evaluate the efficiency of the MOH in providing public health services and to gauge the progress of health plans in Malaysia. Methods Three output variables (number of admissions, number of outpatient attendances, and number of maternal and child health attendances) and six input variables (budget allocation, number of doctors, dentists, pharmacists, nurses, and community nurses) were used in a Data Envelopment Analysis (DEA) Window Analysis. Eight input-output models’ bias-corrected efficiency scores were obtained using bootstrapping. Setting Ministry level in public health service. Participant 28 Decision making units (DMUs) from 1995 to 2022. Results Robust performance over the study period was shown by the mean bias-corrected efficiency score of 0.974 (95% CI: 0.907–0.989) under the Variable Returns to Scale (VRS) model. Lower Constant Returns to Scale (CRS) model scores, on the other hand, draw attention to scale-level inefficiencies. During the COVID-19 pandemic, efficiency decreased due to higher input demands and limited outputs. Conclusions Although MOH has attained a high level of technological efficiency, expanding operations and resolving inequalities in rural areas remain difficult. Targeted tactics including telemedicine adoption, resource redistribution, and a move towards preventive treatment are advised in order to improve fairness and resilience.https://doi.org/10.1186/s13561-025-00624-9Data Envelopment AnalysisBootstrappingEfficiencyMinistry of healthMalaysia |
| spellingShingle | M Zulfakhar Zubir Aizuddin A.N Mohd Rizal Abdul Manaf A Aziz Harith M Ihsanuddin Abas Maizatul Izyami Kayat M Firdaus M Radi Mas Norehan Merican Nurcholisah Fitra Affendi M Ali Sharifah Ain Shameera Syed Rusli Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia Health Economics Review Data Envelopment Analysis Bootstrapping Efficiency Ministry of health Malaysia |
| title | Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia |
| title_full | Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia |
| title_fullStr | Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia |
| title_full_unstemmed | Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia |
| title_short | Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia |
| title_sort | three decades in healthcare service efficiency evaluation a bootstrapping data envelopment analysis dea of ministry of health malaysia |
| topic | Data Envelopment Analysis Bootstrapping Efficiency Ministry of health Malaysia |
| url | https://doi.org/10.1186/s13561-025-00624-9 |
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