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      <JournalTitle>African Journal of Health Economics</JournalTitle>
      <Volume-Issue>Volume 4 Issue 2</Volume-Issue>
      <Season>December 2015</Season>
      <ArticleType>Review &amp; Research</ArticleType>
          <FirstName>Brijesh C</FirstName>
      <Abstract>Keeping in view global awareness about resource utilization in healthcare sector, we focus on efficiency of health care system at sub-state level (i.e., district level) in India using Bihar state and its district level data for 2012-13. In spite of being an economically and socially disadvantaged state, the IMR in Bihar is very close to the all-India average. We explore the reasons for relative performance of different districts with Data Envelopment Analysis. We used IMR as output variables. Using Principal component analysis, we tried a sub-set of variables which had low correlations. Four factor scores relating to safe delivery, less than 24 hours stay in institution after delivery, total numbers having post-natal care, and total numbers having immunization card were used for DEA. We have focused on constant returns to scale technical efficiency. Our results for district level health system efficiency in Bihar indicate that some of the districts have low efficiency in utilization of inputs like doctors, beds and workload per health institutions. There are also other districts which need more of these inputs to enhance their output and efficiency. A mix of inefficiency and inadequacy of inputs is reflected in our results. The funds from national rural health mission (NRHM) towards low performing districts seem to have been optimally targeted. Further exploration in terms of per health institution to observe individual input utilization along with training inputs to health personnel for optimal use of time, manpower and material inputs may help to enhance state health system efficiency.</Abstract>
      <Keywords>Efficiency, healthcare system, district level, IMR.</Keywords>
        <Abstract>https://ajhe.org.in/ubijournal-v1copy/journals/abstract.php?article_id=3069&amp;title=EFFICIENCY IN HEALTH CARE SECTOR IN BIHAR (IND13): AN EXPLORATORY ANALYSIS USING DEA</Abstract>