Evaluating the Impact of Hospital Information Systems on the Technical Efficiency of 8 Central African Hospitals Using Data Envelopment Analysis


  • Frank Verbeke Vrije Universiteit Brussel
  • Evelyne Ndabaniwe Burundi Health Informatics Association
  • Stefaan Van Bastelaere Belgian Technical Cooperation
  • Ousmane Ly Agence Nationale de Télésanté et d'Informatique Médicale
  • Marc Nyssen Vrije Universiteit Brussel




Objectives: this study evaluates the usability of Data Envelopment Analysis (DEA) for analyzing the technical efficiency before and after hospital information system (HIS) implementation for a set of 8 Central African hospitals (6 Rwandan, 2 Burundian; 6 public and 2 private).

Methods: DEA is a method that uses linear programming techniques to produce a relative efficiency score for organizational units where the presence of multiple inputs and outputs makes straightforward comparisons difficult. DEA is non-parametric, requiring no assumptions about the (most often unknown) functional relationship between inputs and outputs (in contrast to regression based models). The method directly compares health facilities against a combination of peers. In this study post-HIS implementation health facility productivity was also compared against results obtained before HIS implementation.

Results: the average technical efficiency increase of 5,04% after HIS implementation appeared not to be statistically significant in our small dataset.

Conclusions: despite the lack of statistical significance, the results still suggest that DEA may offer interesting opportunities for measuring productivity impact of large scale implementations of health information management methods and systems using data sets from heterogeneous collections of health facilities. Further research on an extended set of sub-Saharan health facilities has been programmed for that purpose.

Keywords: Data Envelopment Analysis, Sub-Saharan Africa,Technical efficiency, Hospital Information Systems


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Akazili J, Adjuik M, Jehu-Appiah C, Zere E. Using data envelopment analysis to measure the extent of technical efficiency of public health centres in Ghana. BMC International Health and Human Rights. 2008;8(1):11.

Ramanathan R. An introduction to data envelopment analysis a tool for performance measurement. New Delhi; Thousand Oaks, Calif.: Sage Publications; 2003. Available from: http://public.eblib.com/EBLPublic/PublicView.do?ptiID=475980

Al-Shayea AM. Measuring hospital’s units efficiency: A data envelopment analysis approach. International Journal of Engineering & Technology. 2011 Dec;11(6):7–19.

Cooper WW, Seiford LM, Tone K. Data envelopment analysis a comprehensive text with models, applications, references and DEA-solver software. New York: Springer; 2007. Available from: http://public.eblib.com/EBLPublic/PublicView.do?ptiID=323342

Charnes A, Cooper WW, Rhodes E. Measuring the efficiency of decision making units. European Journal of Operational Research. 1978;2:429–44.

Banker RD, Charnes A, Cooper WW. Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis. Management Science. 1984 Sep 1;30(9):1078–92.

Chattopadhyay S, Ray SC. Technical, scale, and size efficiency in nursing home care: A nonparametric analysis of Connecticut homes. Health Economics. 1996 Jul;5(4):363–73.

Zere E, World Institute for Development Economics Research. Hospital efficiency in Sub-Saharan Africa. Helsinki: United Nations University, World Institute for Development Economics Research; 2000.

Osei D, d’ Almeida S, George MO, Kirigia JM, Mensah AO, Kainyu L h. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study. Cost Effectiveness and Resource Allocation. 2005;3(9). Available from: http://www.resource-allocation.com/content/3/1/9

Bowlin WF, Charnes A, Cooper WW, Sherman HD. Data envelopment analysis and regression approaches to efficiency estimation and evaluation. Annals of Operations Research. 1984 Dec;2(1):113–38.

Australia. Steering Committee for the Review of Commonwealth/State Service Provision, Australia. Industry Commission. Data envelopment analysis : a technique for measuring the efficiency of government service delivery. Melbourne: Industry Commission; 1997.

OpenClinic GA [Internet]. Available from: http://sourceforge.net/projects/open-clinic/

Cheng G. MaxDEA for Data Envelopment Analysis. China Center for Health Development Studies, Beijing University; 2011. Available from: http://www.maxdea.cn

Verbeke F, ICT-based Health Information Management Methods in sub-Saharan Hos-pitals. Brussels: Vrije Universiteit Brussel, VUBPress; 2012.

Open source challenges for hospital information system (HIS) in developing countries: a pilot project in Mali ,Cheick-Oumar Bagayoko, Jean-Charles Dufour, Saad Chaacho, Omar Bouhaddou, Marius Fieschi, Bagayoko et al. BMC Medical Informatics and De-cision Making 2010, 10:22

Implementing electronic medical record systems in developing countries, Hamish SF Fraser, Paul Biondich, Deshen Moodley, Sharon Choi, Burke W Mamlin, Peter Szolovits, Informatics in Primary Care 2005;13:83–95

The rise of open-source electronic health records, Paul C Webster, The Lancet, Volume 377, Issue 9778, Pages 1641 - 1642, 14 May 2011



How to Cite

Verbeke, F., Ndabaniwe, E., Van Bastelaere, S., Ly, O., & Nyssen, M. (2013). Evaluating the Impact of Hospital Information Systems on the Technical Efficiency of 8 Central African Hospitals Using Data Envelopment Analysis. Journal of Health Informatics in Africa, 1(1). https://doi.org/10.12856/JHIA-2013-v1-i1-68

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