Measuring Efficiency Performance in Primary Public Health Clinics, Sarawak, Malaysia

The health care system in Malaysia has undergone various reforms in order to improve its performance. In Malaysia, secondary and tertiary care services are provided by hospitals, while primary care services are supplied by health clinics. Health clinics are constrained with limited resources in providing health services to the public. The optimum utilization of resources in health clinics is thus critical and warrants empirical investigation. Using data envelopment analysis (DEA) by employing three inputs and three outputs of 32 decision-making units (DMUs), this study aims to measure the technical efficiency and scale efficiency of health clinics in Samarahan District, Sarawak. Data was drawn from 16 public health clinics in the district over 2 years from 2015 to 2016. Our results show that only 34.37% of health clinics are operating at the efficient scale of production within the most productive scale size (MPSS), while the remaining 65.63% of health clinics either experience increasing returns to scale (37.50%) or diminishing returns to scale (28.13%). 68.75% of health clinics are technically efficient while only 31.25% are technically inefficient. The article advances several public policy recommendations for improving the performance of the health clinics.