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Open Access 01-12-2017 | Research article

Technical efficiency of rural primary health care system for diabetes treatment in Iran: a stochastic frontier analysis

Authors: Mostafa Qorbani, Farshad Farzadfar, Reza Majdzadeh, Kazem Mohammad, Abbas Motevalian

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2017

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Abstract

Background

Our aim was to explore the technical efficiency (TE) of the Iranian rural primary healthcare (PHC) system for diabetes treatment coverage rate using the stochastic frontier analysis (SFA) as well as to examine the strength and significance of the effect of human resources density on diabetes treatment.

Methods

In the SFA model diabetes treatment coverage rate, as a output, is a function of health system inputs (Behvarz worker density, physician density, and rural health center density) and non-health system inputs (urbanization rate, median age of population, and wealth index) as a set of covariates. Data about the rate of self-reported diabetes treatment coverage was obtained from the Non-Communicable Disease Surveillance Survey, data about health system inputs were collected from the health census database and data about non-health system inputs were collected from the census data and household survey.

Results

In 2008, rate of diabetes treatment coverage was 67% (95% CI: 63%–71%) nationally, and at the provincial level it varied from 44% to 81%. The TE score at the national level was 87.84%, with considerable variation across provinces (from 59.65% to 98.28%).Among health system and non-health system inputs, only the Behvarz density (per 1000 population)was significantly associated with diabetes treatment coverage (β (95%CI): 0.50 (0.29–0.70),p < 0.001).

Conclusion

Our findings show that although the rural PHC system can considered efficient in diabetes treatment at the national level, a wide variation exists in TE at the provincial level. Because the only variable that is predictor of TE is the Behvarz density, the PHC system may extend the diabetes treatment coverage by using this group of health care workers.
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Metadata
Title
Technical efficiency of rural primary health care system for diabetes treatment in Iran: a stochastic frontier analysis
Authors
Mostafa Qorbani
Farshad Farzadfar
Reza Majdzadeh
Kazem Mohammad
Abbas Motevalian
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Diabetes & Metabolic Disorders / Issue 1/2017
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1186/s40200-017-0312-8

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