Regional Surgical Systems Response to COVID-19 Pandemic—Preliminary Insights Through Longitudinal DEA

Goal: The objectives of this benchmarking study are: (1) to evaluate the efficiency changes, and; (2) to elicit factors associated with efficiency improvements for surgical systems in South and Southeast Asia during the COVID-19 pandemic. Methods: We performed a two-stage benchmarking analysis for 9 hospital and health services (HHS) across 6 countries from Jan 2020 till Dec 2021. The first stage involves quantifying efficiency changes in response to COVID-19 via the Malmquist Index (MI). The second stage evaluates an explanatory model to elicit the factors associated with efficiency improvements. Results: Over the study period, the trend in MIs reveals that the countries started with low efficiency improvement during the initial phases of the pandemic. The situation improved with efficiency gains varying over the course of the pandemic due to the dynamically evolving policies, resurgence of new variants and introduction of vaccines. Measures related to safeguarding the wellbeing of healthcare workers and preserving the structural capacity of HHS during the pandemic are found to be significantly associated with improvements in efficiency. Conclusion: This benchmarking study allows us to evaluate the relative efficiencies of health systems in dealing with the pandemic and to identify the best practices associated with efficiency improvements. Our analysis framework provides HHS- and country-specific insight that will help to inform policy responses to future public health crises.