Efficiency, quality, and management practices in multidisciplinary and traditional diabetes healthcare services in Mexico

Abstract

AbstractDiabetes is a major health issue in middle-income countries like Mexico. Multidisciplinary healthcare (MHC) models aim to improve diabetes care and reduce costs. However, the relationship between management practices, efficiency, and quality of care in MHC and traditional healthcare (THC) models is unclear. This study evaluates the efficiency and quality of diabetes healthcare models in Mexico, identifying associated management practices. Methodology. Data from a retrospective longitudinal analysis were used to compare 20 THC and 20 MHC. Technical efficiency (TE) scores were estimated using data envelopment analysis (DEA), quality scores were calculated based on provider competence and patient performance. The relationship between efficiency, quality, and management practices was analyzed using positive deviance regression. Results. DEA analysis indicate higher TE in MHC units (mean score: 65, SD = 19) compared to THC units (mean score: 24, SD = 23). MHC units scored 78.55 (SD = 18.71) in performance score, while THC units scored 37.7 (SD = 18.97). MHC units also outperformed THC units in competence scores (mean: 68.71, SD = 18.31 vs. 49.97, SD = 23.31). Several management practices were associated with best performance in terms of both efficiency and quality strategic thinking, human resource management, financial management, operations management, performance management, and governance. Conclusion. This study highlights the higher efficiency of MHC models in diabetes care compared to THC models in Mexico. However, both models require improvement in quality. Understanding the relationship between management practices, efficiency, and quality can guide policymakers in enhancing diabetes care in low- and middle-income countries.