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Innovative Approach to Efficiency Measurement Using the DEABSC Method in the Public Health Service of Croatia

Contemporary health care systems face the problem how to ensure efficient and equitable health care for all citizens when sources of funding are limited. The task of public health services is to improve population's health and they therefore comprise a series of improvement measures. Many of the health care reforms in different countries are conducted with the objectives to rationalize costs, to make health services more available, and to increase or at least not to reduce quality of health services. The subject of this research is efficiency measurement in the institutes of public health services in the Croatia which are oriented to prevention activities i.e. monitoring, analysis, and evaluation of the health of the population. Diversity of the programs and temporal variability are characteristics of public health services and therefore harder to measure the effects in the long run. This research has the aim to analyses and proposes the new approach in the measurement system using two combined methods DEA and BSC. DEABSC integrative model provides a holistic approach to the management and can be an efficient method for decision – making process. The starting point of this research is the analysis of the measurement system in the public health services in the Croatia. The results confirm weak and inadequate efficiency measurement system and very low effectiveness measurement. To enhance the efficiency measurement we develop conceptual integrative DEABSC model which has been tested on the Teaching Institute of Public Health in one of the County. Using DEA for the period from 2014 to 2015 we identify relatively inefficient units which help management to adjust organization structure and processes. Combining DEA with the BSC this research helps to identify the possibilities for improving the effectiveness of public health services programs. The study confirms that it is possible to determine relative efficiency of different DMUs within the Department of Health Ecology and use the best practice for each perspective in the BSC Cause & Effect model. Even more this paper provides recommendations how easier to manage resources in order to achieve the mission of public health institutions but also indicates some limitations when applying methods.

efficiency measurement, DEA, BSC, public health services

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