Technical efficiency and its influencing factors in Malaysian hospital pharmacy services.

Various pharmacy services are offered in public health facilities, ranging from distributive activities (dispensing) to patient-oriented services (pharmaceutical care). These activities are monitored through indicators established at the national level. In Malaysia, the indicators have not been transformed into a measurement of hospital pharmacy service efficiency. The main objectives of this study were to assess the relative performance of hospital pharmacy services and to investigate the factors that may affect the performance levels. Double-bootstrap data envelopment analysis was applied to measure the technical efficiency levels of 124 public hospital pharmacies in 2014. An input-oriented variable returns to scale model was adopted in the study, while bootstrap truncated regression was conducted to identify the factors that may explain the differences in the efficiency levels. The average bias-corrected technical efficiency score varies according to the hospital size (0.84, 0.78 and 0.82 in small, medium and large hospitals, respectively). The hospital size, hospital age, urban location and information technology are important determinants of the efficiency levels. The study contributes to establishing baseline technical efficiency information for public hospital pharmacy services in Malaysia. The measurement of hospital pharmacy efficiency can guide future policy making to improve performance and ensure the optimum level of available resources.