Analysis of the sources of productivity change in Togo public hospitals: Hicks-Moorsteen’s productivity index

Abstract

From 60% in 1990, attendance at public hospitals in Togo has declined significantly and is estimated at
30.08% in 2010. Less than half of child deliveries took place in these hospitals. From 2008 to 2012, it was
noted that there was an average increase of patient deaths by 10%. This study aims at analyzing the sources
of productivity changes in Togo public hospitals. The Hicks-Moorsteen’s productivity index was used to
analyze the productivity changes of 139 public hospitals over a period of four years (2008-2011). On average,
productivity has declined significantly over the study period. This decrease is explained by the level of
efficiency of large hospitals. The low level of efficiency of large hospitals is mainly due to a deficiency in the
maintenance of medical equipment, aging biomedical equipment, lack of physicians, and inadequate
infrastructure. Improving technical efficiency observed was found to be insufficient to increase productivity.
The results suggest that the increase of technical efficiency has not yet reached the threshold required to
trigger growth in productivity. Increasing technical efficiency would be the first goal to be set for improving
public hospitals productivity. It should, also, encourage new investment that would improve production
technology