Benchmarking the operational efficiency of Mexican hospitals – a longitudinal study.

Purpose: This study aims to benchmark the operational efficiency of fifty-eight public hospitals across Mexico between 2015 and 2018 and identifies the most critical inputs affecting their efficiency. In doing so, the study analyzes the impact of policy changes in the Mexican healthcare system introduced in recent years. Design/methodology/approach: To measure the operational efficiency of Mexican public hospitals, data envelopment analysis (DEA) window analysis variable returns to scale (VRS) methodology using longitudinal data collected from the National Institute for Transparency and Access to Information (IFAI). Hospital groups are developed and compared using a categorization approach according to their average and most recent efficiency. Findings: Results show that most of the hospitals in the study fall in the moving ahead category. The hospitals in the losing momentum or falling behind categories are mostly large units. Hospitals with initially low efficiency scores have either increased their efficiency or at least maintained a steady improvement. Finally, the findings indicate that most hospitals classified as moving ahead focused on a single care area (cancer, orthopedic care, child care and trauma). Research limitations/implications: This study examined the technical efficiency of the Mexican healthcare system over a four-year period. Contrary to conventional belief, results indicate that most public Mexican hospitals are managed efficiently. However, recent changes in public and economic policies that came into effect in the current administration (2018) will likely have long-lasting effects on the hospitals' operational efficiency, which could impact the results of this study. Originality/value: To the best of authors' knowledge, this is the first study that examines the efficiency of the complex Mexican healthcare system using longitudinal data. [ABSTRACT FROM AUTHOR]