Increasing the performance of Egyptian public general hospitals: Towards equity and efficiency through incentives

Hospitals in Egypt are approaching a time of change during which they will be required to assess their roles and the way they function as organizations. Health sector reform initiatives requiring greater autonomy and accountability are being pushed by international donors and internal stakeholders. The Ministry of Health and Population is being asked to take on the role of policymaker rather than provider. The goal of delivering efficient services in an equitable manner is paramount as reforms are sought.;This dissertation addresses the need for equity and efficiency in the Egyptian public general hospitals as these changes take place. It does this by developing a framework for analyzing the efficiency of Egyptian public general hospitals. Through creating greater efficiencies in curative care, funds can be reallocated to the more cost beneficial preventive services needed for the public health of the country.;Four papers are included. The first addresses the measurement of readiness for change and the incentives needed to bring about those changes. The second paper introduces the key indicators to be used in measuring efficiency, applying them to total hospital operations. The next two provide analysis of the performance of two services within the seven public general hospitals. Inefficiencies were identified in all hospitals and departments. The concluding chapter ties together the analytical framework developed in the first paper with the recommendations from the performance analysis.;Data for the analysis of the hospitals and their reproductive and orthopedic services were obtained through the Data for Decision Making project, a joint effort of the Directorate of Planning of the Ministry of Health and Population, the Harvard School of Public Health and the University of California Berkeley School of Public Health.;The papers are meant to provide practical guidance in analyzing the performance of public general hospitals and direction for making the needed changes. It is hoped that these tools will be taken and used in the field as part of the health sector reform process in developing countries.