TY - JOUR ID - 3215 TI - Measuring the Capacity Utilization of Public District Hospitals in Tunisia: Using Dual Data Envelopment Analysis Approach JO - International Journal of Health Policy and Management JA - IJHPM LA - en SN - AU - Arfa, Chokri AU - Leleu, Hervé AU - Goaïed, Mohamed AU - van Mosseveld, Cornelis AD - Iational Institute of Labour and Social Studies (INTES), University of Carthage, Tunisia, Tunis AD - LEM-CNRS, IÉSEG School of Management, Lille, France AD - LEFA-IHEC, University of Carthage, Tunisia, Tunis AD - Health Economist Expert (free lance) Y1 - 2017 PY - 2017 VL - 6 IS - 1 SP - 9 EP - 18 KW - Data Envelopment Analysis (DEA) KW - Shadow Prices KW - Capacity Utilization (CU) KW - Public District Hospitals KW - (PDHs) KW - Tunisia DO - 10.15171/ijhpm.2016.66 N2 - Background Public district hospitals (PDHs) in Tunisia are not operating at full plant capacity and underutilize their operating budget.   Methods Individual PDHs capacity utilization (CU) is measured for 2000 and 2010 using dual data envelopment analysis (DEA) approach with shadow prices input and output restrictions. The CU is estimated for 101 of 105 PDH in 2000 and 94 of 105 PDH in 2010.   Results In average, unused capacity is estimated at 18% in 2010 vs. 13% in 2000. Of PDHs 26% underutilize their operating budget in 2010 vs. 21% in 2000.   Conclusion Inadequate supply, health quality and the lack of operating budget should be tackled to reduce unmet user’s needs and the bypassing of the PDHs and, thus to increase their CU. Social health insurance should be turned into a direct purchaser of curative and preventive care for the PDHs. UR - https://www.ijhpm.com/article_3215.html L1 - https://www.ijhpm.com/article_3215_e75624de1e0e6d3d6b1e0c8e80a73498.pdf ER -