The determinants of the economic and financial standing of the public hospitals in Senegal

In Senegal, the context of the hospital payment system and financing of hospitals explains the difficulties of access to health care for the population. Currently, the public hospitals have two sources of financing: the global... [ view full abstract ]

In Senegal, the context of the hospital payment system and financing of hospitals explains the difficulties of access to health care for the population. Currently, the public hospitals have two sources of financing: the global budget of government and the appropriate receipts through care prices defined in a price range. However, the global budget of these hospitals doesn’t suffice generally. Then, our paper deals with the economic and financial standing of the public hospitals in Senegal, and identifies the determinants of the hospital operating deficit.

Our objective consists to analyze the efficiency of the politics of global budget in order to detect the real problems of hospital deficit in Senegal.
We use a panel data for a sample of public hospitals from 2007 to 2011.

The results underline, on the one hand, the negative and significant influences of the average bed occupancy rate and global budget; and on the other hand, the positive and significant effects of the average length of stay (variable of activity) on the hospital operating deficit.

As teaching, we can say:
Firstly, the politics of global budget has not been effective to absorb the hospital operating deficit. The inefficiency is due to the existence of asymmetric information between the government and the hospitals.

Secondly, an efficient financing should be based on hospital activity. Then, we propose to reform the financial system of the public hospitals, with a view to take into account hospital activity in health care budget. It’s about the “activity financing”.

Thirdly, this reform would present a real advance in the adequacy of the budget to the reality of hospital activity. Besides, it would enable to decrease the hospital budgetary deficit and to reduce the inequalities of access to health care for the population.

Key words: public hospital, financing, operating deficit, panel data, activity.