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There is a general perception that public healthcare service delivery is deteriorating severely, despite government commitments to change this. This dysfunction stems from the cumulative impact of burden of diseases, economic pressures, population surge, policy and strategy incoherence and managerial incompetence. The core objective of this qualitative research study therefore, is to gain insight into the cause-effects of this sub-minimal performance, patients’ dissatisfaction and the waste of resources in Gauteng’s public healthcare sectors, with an intention to provide recommendations in resolving this crisis and to further this research.
This research made use of Performance Assessment Tools for quality improvement in Hospitals (PATH) framework and Data Envelopment Analysis (DEA) to evaluate the satisfaction levels, performance and technical efficiencies of public hospitals, which were compared to the private sector.
The findings agree that the satisfaction of patients is poor, performance sub-minimal and technically inefficient and health outcomes unsatisfactory relative to private hospitals. Patients’ dissatisfaction level was 76%. The efficiency constant returns to scale (CRS) were (40%), (63%) and (100%) respectively for district, regional and private hospitals while their variable returns to scale (VRS) were 60%, 37% and 100% with scale efficiency score of 92%, 52% and 100 % in that order. Health outcomes such as patients re-admission within a 28-day period recorded 20%, 21%, <5% for the district, regional and private hospitals respectively, and PHC health outcome (25%).
The lack of patient satisfaction, performance slack and inefficiency resulted partly from overall poor decision-making abilities on the use and allocation of resources and the lack of integrated information systems in the facilities