Efficiency of human resources in public hospitals: An example from the Czech Republic

Abstract

Healthcare is a highly sophisticated segment of the public sector, which requires not only highly professional and competent staff, but also a properly set ratio of healthcare professionals. In the Czech Republic, the state, as the main guarantor of health care, applied strong control through price and volume control. The aim of the paper is to define the differences in the technical efficiency of public hospitals, with regard to the size of hospitals and partial types of human resources. An input-oriented Data Envelopment Analysis model (DEA model) was chosen for modeling the technical efficiency of 47 public hospitals. The personnel performance concept of the evaluation of technical efficiency was further implemented in eight specific models, from the perspective of individual input variables relative to output variables and according to different assumptions regarding the character of economies of scale. The results of technical efficiency were analyzed using correlation, regression analysis, and the Bootstrap method. The least efficient hospitals in terms of hospital size are large hospitals, and the most balanced results have been achieved by medium-sized hospitals. The average efficiency rate in models that include all selected input and output variables is highest in medium-sized hospitals, with a value of 0.866 for CRS and an efficiency rate of 0.926 for VRS. The rationalization of human resources should be implemented in order not to reduce the quality of care provided.