Performance of Hospitals in Cross River State, Nigeria: A Comparative Analysis of Rural and Urban Public Secondary Care Institutions Using Productivity Indicators
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This study analysed the performance of secondary care hospitals in Cross River State using simple productivity ratios with data for the period 2010- 2014. Three categories of simple productivity ratios with a total of five indicators were analysed. The study analysed labour productivity using number of admissions per employee and number of admissions per nurse; capital productivity using number of admissions per bed; and structural quality indicators using number of nurses per bed and number of doctors per bed. There were productivity improvements for nine hospitals in admissions per bed and ten for admissions per nurse while productivity was static or declined in three and one hospital respectively for these labour productivity indicators. Nine hospitals witnessed capital productivity improvements while five had improvements in hospital quality. Rural hospitals were more labour productive while urban hospitals were more capital productive showing a relatively higher improvement in quality. The relative low productivity of labour in urban hospitals, with more employees, points to some level of labour redundancy in these hospitals which may result in wastage of resources spent on human personnel without a commensurate input in terms of man hours. Capital provision in rural hospitals, labour and hospital quality productivity improving measures such as remuneration for hours of work done and specialized staff/nursing training could enhance productivity of public secondary care hospitals in the state.