A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Edson Serván-Mori; Miguel Ángel Mendoza; Carlos Chivardi; Carlos Pineda-Antúnez; Roxana Rodríguez-Franco; Gustavo Nigenda

doi:10.1002/hpm.2785

A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Edson Serván-Mori, Miguel Ángel Mendoza, Carlos Chivardi, Carlos Pineda-Antúnez, Roxana Rodríguez-Franco, Gustavo Nigenda

Centre for Health Economics

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To analyze the formation of spatial clusters of technical efficiency (TE) in the production of outpatient maternal health services in México for the period 2008 to 2015.

METHODS: We performed a longitudinal analysis of administrative and structural data related to the 243 Mexican health jurisdictions. We use window data envelopment analysis and spatial and econometric techniques. Structural correlates of each TE cluster obtained were identified estimating a pooled multinomial logit model.

RESULTS: We observed an increase in the overall TE, accompanied by a reduction in its standard deviation. Furthermore, we identified positive TE spatial dependence both globally and locally. Multiple regression analysis showed that the maximum-performance TE cluster was composed of health jurisdictions located in the North of México and characterized by social marginalization, a reduced indigenous population, and a low demand for maternal health services.

CONCLUSIONS: The identification of TE clusters can provide elements to induce decision makers to innovative in ways of allocating resources and manage their utilization. In México as other low- and middle-income countries, it is key to develop targeting strategies to implement specific health services innovations putting to the population to be served at the front of the strategy. This implies testing new modalities to strengthen primary health services, the empowerment of community participation, the training and allocation of health personnel that could respond adequately to population's demand, and the active involvement of competent state and local authorities in the assessment of the results of these innovations.

Original language	English
Pages (from-to)	e1417-e1436
Journal	The International journal of health planning and management
Volume	34
Issue number	4
DOIs	https://doi.org/10.1002/hpm.2785
Publication status	Published - Oct 2019

Bibliographical note

Keywords

Ambulatory Care/organization & administration
Efficiency, Organizational/statistics & numerical data
Humans
Longitudinal Studies
Maternal Health Services/organization & administration
Mexico
Models, Organizational
Models, Statistical
Regional Medical Programs/organization & administration
Spatio-Temporal Analysis

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10.1002/hpm.2785

Cite this

Serván-Mori, E., Mendoza, M. Á., Chivardi, C., Pineda-Antúnez, C., Rodríguez-Franco, R., & Nigenda, G. (2019). A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México. The International journal of health planning and management, 34(4), e1417-e1436. https://doi.org/10.1002/hpm.2785

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title = "A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in M{\'e}xico",

abstract = "OBJECTIVE: To analyze the formation of spatial clusters of technical efficiency (TE) in the production of outpatient maternal health services in M{\'e}xico for the period 2008 to 2015.METHODS: We performed a longitudinal analysis of administrative and structural data related to the 243 Mexican health jurisdictions. We use window data envelopment analysis and spatial and econometric techniques. Structural correlates of each TE cluster obtained were identified estimating a pooled multinomial logit model.RESULTS: We observed an increase in the overall TE, accompanied by a reduction in its standard deviation. Furthermore, we identified positive TE spatial dependence both globally and locally. Multiple regression analysis showed that the maximum-performance TE cluster was composed of health jurisdictions located in the North of M{\'e}xico and characterized by social marginalization, a reduced indigenous population, and a low demand for maternal health services.CONCLUSIONS: The identification of TE clusters can provide elements to induce decision makers to innovative in ways of allocating resources and manage their utilization. In M{\'e}xico as other low- and middle-income countries, it is key to develop targeting strategies to implement specific health services innovations putting to the population to be served at the front of the strategy. This implies testing new modalities to strengthen primary health services, the empowerment of community participation, the training and allocation of health personnel that could respond adequately to population's demand, and the active involvement of competent state and local authorities in the assessment of the results of these innovations.",

keywords = "Ambulatory Care/organization & administration, Efficiency, Organizational/statistics & numerical data, Humans, Longitudinal Studies, Maternal Health Services/organization & administration, Mexico, Models, Organizational, Models, Statistical, Regional Medical Programs/organization & administration, Spatio-Temporal Analysis",

author = "Edson Serv{\'a}n-Mori and Mendoza, {Miguel {\'A}ngel} and Carlos Chivardi and Carlos Pineda-Ant{\'u}nez and Roxana Rodr{\'i}guez-Franco and Gustavo Nigenda",

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year = "2019",

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Serván-Mori, E, Mendoza, MÁ, Chivardi, C, Pineda-Antúnez, C, Rodríguez-Franco, R & Nigenda, G 2019, 'A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México', The International journal of health planning and management, vol. 34, no. 4, pp. e1417-e1436. https://doi.org/10.1002/hpm.2785

A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México. / Serván-Mori, Edson; Mendoza, Miguel Ángel; Chivardi, Carlos et al.
In: The International journal of health planning and management, Vol. 34, No. 4, 10.2019, p. e1417-e1436.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - A spatio-temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

AU - Serván-Mori, Edson

AU - Mendoza, Miguel Ángel

AU - Chivardi, Carlos

AU - Pineda-Antúnez, Carlos

AU - Rodríguez-Franco, Roxana

AU - Nigenda, Gustavo

PY - 2019/10

Y1 - 2019/10

N2 - OBJECTIVE: To analyze the formation of spatial clusters of technical efficiency (TE) in the production of outpatient maternal health services in México for the period 2008 to 2015.METHODS: We performed a longitudinal analysis of administrative and structural data related to the 243 Mexican health jurisdictions. We use window data envelopment analysis and spatial and econometric techniques. Structural correlates of each TE cluster obtained were identified estimating a pooled multinomial logit model.RESULTS: We observed an increase in the overall TE, accompanied by a reduction in its standard deviation. Furthermore, we identified positive TE spatial dependence both globally and locally. Multiple regression analysis showed that the maximum-performance TE cluster was composed of health jurisdictions located in the North of México and characterized by social marginalization, a reduced indigenous population, and a low demand for maternal health services.CONCLUSIONS: The identification of TE clusters can provide elements to induce decision makers to innovative in ways of allocating resources and manage their utilization. In México as other low- and middle-income countries, it is key to develop targeting strategies to implement specific health services innovations putting to the population to be served at the front of the strategy. This implies testing new modalities to strengthen primary health services, the empowerment of community participation, the training and allocation of health personnel that could respond adequately to population's demand, and the active involvement of competent state and local authorities in the assessment of the results of these innovations.

AB - OBJECTIVE: To analyze the formation of spatial clusters of technical efficiency (TE) in the production of outpatient maternal health services in México for the period 2008 to 2015.METHODS: We performed a longitudinal analysis of administrative and structural data related to the 243 Mexican health jurisdictions. We use window data envelopment analysis and spatial and econometric techniques. Structural correlates of each TE cluster obtained were identified estimating a pooled multinomial logit model.RESULTS: We observed an increase in the overall TE, accompanied by a reduction in its standard deviation. Furthermore, we identified positive TE spatial dependence both globally and locally. Multiple regression analysis showed that the maximum-performance TE cluster was composed of health jurisdictions located in the North of México and characterized by social marginalization, a reduced indigenous population, and a low demand for maternal health services.CONCLUSIONS: The identification of TE clusters can provide elements to induce decision makers to innovative in ways of allocating resources and manage their utilization. In México as other low- and middle-income countries, it is key to develop targeting strategies to implement specific health services innovations putting to the population to be served at the front of the strategy. This implies testing new modalities to strengthen primary health services, the empowerment of community participation, the training and allocation of health personnel that could respond adequately to population's demand, and the active involvement of competent state and local authorities in the assessment of the results of these innovations.

KW - Ambulatory Care/organization & administration

KW - Efficiency, Organizational/statistics & numerical data

KW - Humans

KW - Longitudinal Studies

KW - Maternal Health Services/organization & administration

KW - Mexico

KW - Models, Organizational

KW - Models, Statistical

KW - Regional Medical Programs/organization & administration

KW - Spatio-Temporal Analysis

U2 - 10.1002/hpm.2785

DO - 10.1002/hpm.2785

M3 - Article

C2 - 31190458

SN - 0749-6753

VL - 34

SP - e1417-e1436

JO - The International journal of health planning and management

JF - The International journal of health planning and management

IS - 4

ER -