Metafrontier efficiency analysis for hospital pharmacy services using dynamic network DEA framework

Abstract

Medication management is a complex but critical process within the healthcare delivery system. The pharmacy department in healthcare facilities is responsible for acquisition, distribution and dispensing of medication to patients that involves a series of network process. This process can be categorized into two main subprocesses: i) pharmacy store and ii) patient services (i.e., ambulatory and inpatient pharmacy). The objective of this study was to investigate the relative efficiency level of the two subprocesses of pharmacy services in Malaysia's public hospitals. We used a nonconvex metafrontier technology to estimate technical efficiency of hospital pharmacies between specialist and nonspecialist hospital categories under the dynamic network data envelopment analysis (DNDEA) framework. For overall efficiency, both specialist and nonspecialist categories had similar mean efficiency scores. However, when measuring the efficiency level according to pharmacy store and patient services separately, the nonspecialist category had a higher mean efficiency score in pharmacy store, whereas for patient service efficiency, both categories had similar results. The patient service efficiency level was lower consistently over time, suggesting that the overall inefficiency of hospital pharmacy is greatly influenced by the inefficiency of the patient service. This suggests that systematic improvements in patient service efficiency should be a higher priority than pharmacy store efficiency to further increase the overall efficiency level. We believe that our findings will provide valuable information to policymakers towards achieving an efficient public healthcare service.